Provider Demographics
NPI:1902050271
Name:SKLAR, GARRY STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:GARRY
Middle Name:STEPHEN
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 1:750 DANIEL ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-3502
Mailing Address - Country:US
Mailing Address - Phone:516-569-3881
Mailing Address - Fax:
Practice Address - Street 1:750 DANIEL ST
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-3502
Practice Address - Country:US
Practice Address - Phone:516-569-3881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106424207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB42786Medicare UPIN