Healthcare Provider Details

I. General information

NPI: 1093741605
Provider Name (Legal Business Name): ARTHUR JAY SKLUT PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 COURT ST
PLYMOUTH MA
02360-3822
US

IV. Provider business mailing address

542 KIRBY ST
NEW BEDFORD MA
02740-1444
US

V. Phone/Fax

Practice location:
  • Phone: 508-747-2718
  • Fax: 508-747-5209
Mailing address:
  • Phone: 508-984-8234
  • Fax: 508-984-8234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4615
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: