Maryanne R Ilnickij, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

174485 Issued in NY

Practice address

2 Windfield LN
Troy, NY 12180-9651

Phone

(518) 279-4461

Fax

(518) 279-3078

NPI assigned

Aug 23, 2005

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1609869924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WINDFIELD LN",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121809651",
            "telephone_number": "518-279-4461",
            "fax_number": "518-279-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WINDFIELD LN",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121809651",
            "telephone_number": "518-279-4461",
            "fax_number": "518-279-3078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILNICKIJ",
        "first_name": "MARYANNE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2011-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "174485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01305128",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Jon Huyck, M.D.
• Elizabeth Hyde, FNP
• Paige Marie Hyder, FNP-BC
• Samuel M Hykin, M.D.
• Bushra Iftikhar, MD
• Independent Living Center of the Hudson Valley, Inc.
• Theodore Michael Ines, PHD
• Tammy Lynn Ingraham, P.T.A.
• Irectorhudson Mohawk Recovery Center
• Rasheena Irving

• Internal Medicine Physician in Troy, NY
• Providers in Troy, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.