Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 205957-1 | NY |
N | 207ND0900X | Dermatopathologist | 205957-1 | NY |
NPI | 1356308902 |
---|---|
Provider Name | Dr. Debra Lynn Skopicki |
First Address | Woodmere, NY 11598-1204 |
Second Address | Woodmere, NY 11598-1204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 24/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07U041 | BCBS (01) | NY |
G00449 | (02) |