Larisa Ilyutovich
Dentist, General Practice in Fort Lee, New Jersey
1780033225- Practice location
- 301 Bridge Plz N, Suite 2, Fort Lee, NJ 07024-5059
- Phone
- 201-346-4660
- Fax
- 201-346-1116
- Last updated
- June 6, 2016
Larisa Ilyutovich is a Dentist, General Practice based in Fort Lee, NJ. Larisa Ilyutovich practices in Fort Lee, NJ. The NPI Number for Larisa Ilyutovich is 1780033225 and holds a License No. DI020299 (NJ). The current practice location address for Larisa Ilyutovich is 301 Bridge Plz N, Suite 2, Fort Lee, NJ 07024-5059 and can be reached out via phone at 201-346-4660 and via fax at 201-346-1116.
Provider Profile Details
- NPI Number
- 1780033225
- Provider Name
- Larisa Ilyutovich
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 301 Bridge Plz N, Suite 2, Fort Lee, NJ 07024-5059
- Phone Number
- 201-346-4660
- Fax Number
- 201-346-1116
- Primary Taxonomy
- Dentist, General Practice · 1223G0001X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- June 6, 2016
- Last Update Date
- June 6, 2016
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 301 Bridge Plz N
Suite 2
Fort Lee, NJ 07024-5059 - City
- Fort Lee
- State
- New Jersey
- Zip
- 07024-5059
- Phone Number
- 201-346-4660
- Fax Number
- 201-346-1116
Provider Business Mailing Address Details
- Address
- 301 Bridge Plz N
Suite 2
Fort Lee, NJ 07024-5059 - City
- Fort Lee
- State
- NJ
- Zip
- 07024-5059
- Phone Number
- 201-346-4660
- Fax Number
- 201-346-1116
License Information
- License Number
- DI020299
- License State
- NJ
- Taxonomy
- Dentist, General Practice · 1223G0001X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Larisa Ilyutovich?
The NPI number of Larisa Ilyutovich is 1780033225. It was assigned on June 6, 2016 and is currently active in the NPPES registry.
What is the specialty of Larisa Ilyutovich?
Larisa Ilyutovich is registered under the primary taxonomy Dentist, General Practice (code 1223G0001X), licensed in NJ under license number DI020299.
Where does Larisa Ilyutovich practice?
The practice location is 301 Bridge Plz N, Suite 2, Fort Lee, NJ 07024-5059. The office can be reached at 201-346-4660 (phone) or 201-346-1116 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1780033225 directly on the NPPES registry website.