Provider Demographics
NPI:1104898204
Name:SKLAR, JEFFREY ALAN (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ALAN
Last Name:SKLAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WOODBURY RD
Mailing Address - Street 2:STE A
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-2503
Mailing Address - Country:US
Mailing Address - Phone:516-496-9400
Mailing Address - Fax:516-496-9212
Practice Address - Street 1:800 WOODBURY RD
Practice Address - Street 2:STE A
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-2503
Practice Address - Country:US
Practice Address - Phone:516-496-9400
Practice Address - Fax:516-496-9212
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY155263207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology