Leyngold, Ilya M

Leyngold, Ilya M is an individual health care provider with primary practice located at 3015 E Goldstone Dr # 130 , Meridian ID 83642-1549. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery is his primary health care specialty. Leyngold, Ilya M can be contacted via phone (208) 900-4673.

Contact Information

Primary practice address
3015 E Goldstone Dr # 130 Meridian ID 83642-1549
Phone: (208) 900-4673
Fax: (208) 266-5033
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X ME112787 Florida
Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery 207WX0200X ME112787 Florida
Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery 207WX0200X 2016-00134 North Carolina

Profile Details

NPI number 1407996176
LBN Legal business name Leyngold, Ilya M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2007
Last updated Nov 10th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407996176 NPPES
Florida Other 14L01 BLUE CROSS BLUE SHIELD
Florida MEDICAID 005984000 BLUE CROSS BLUE SHIELD
Florida Other 20024216 BLUE CROSS BLUE SHIELD

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