Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 238565-1 | NY |
N | 111NI0900X | Internist | 238565-1 | NY |
N | 207R00000X | Internist | 25MA08408500 | NJ |
N | 111NI0900X | Internist | 25MA08408500 | NJ |
Y | 207RC0000X | Internist - Cardiovascular Disease | 238565 | NY |
N | 207RC0000X | Internist - Cardiovascular Disease | 25MA08408500 | NJ |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 230935 | MA |
NPI | 1013050400 |
---|---|
Provider Name | Eduard Sklyar |
First Address | Bronx, NY 10457-7606 |
Second Address | Bronx, NY 10457 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 25/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0173223 | (05) | NJ |