Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 25MA08628700 | NJ |
NPI | 1437205929 |
---|---|
Provider Name | Justin Michael Skripak |
First Address | Tarrytown, NY 10591-5139 |
Second Address | Oradell, NJ 07649-1524 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 01/04/2019 |