Provider Demographics
NPI:1215329693
Name:ILLESCAS, KARINA (MDCM)
Entity type:Individual
Prefix:DR
First Name:KARINA
Middle Name:
Last Name:ILLESCAS
Suffix:
Gender:F
Credentials:MDCM
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Mailing Address - Street 1:30 RICKER RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-2148
Mailing Address - Country:US
Mailing Address - Phone:347-348-5121
Mailing Address - Fax:
Practice Address - Street 1:525 E 68TH STREET, BOX 141, DEPARTMENT OF RADIOLOGY
Practice Address - Street 2:NEWYORK-PRESBYTERIAN - WEILL CORNELL MEDICAL COLLEGE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4885
Practice Address - Country:US
Practice Address - Phone:212-746-6000
Practice Address - Fax:646-962-0122
Is Sole Proprietor?:No
Enumeration Date:2015-02-23
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2784102085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology