Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 2090441 | NY |
Y | 208D00000X | General Practice Physician | 2090441 | NY |
NPI | 1538389788 |
---|---|
Provider Name | Dr. Bari M Sklar |
First Address | Commack, NY 11725 |
Second Address | Commack, NY 11725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2007 |
Last Update Date | 06/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G61614 | (02) |