Provider Demographics
NPI:1801167150
Name:D'ATRI, ILVIRA (DPM)
Entity type:Individual
Prefix:DR
First Name:ILVIRA
Middle Name:
Last Name:D'ATRI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:ILVIRA
Other - Middle Name:
Other - Last Name:ISYANOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:3049 BRIGHTON 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6409
Mailing Address - Country:US
Mailing Address - Phone:917-620-9187
Mailing Address - Fax:718-934-0994
Practice Address - Street 1:57 HARRISON ST
Practice Address - Street 2:
Practice Address - City:HAWORTH
Practice Address - State:NJ
Practice Address - Zip Code:07641-1920
Practice Address - Country:US
Practice Address - Phone:917-620-9187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006443213ES0103X
NJ25MD00312800213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery