Healthcare Provider Details

I. General information

NPI: 1023621240
Provider Name (Legal Business Name): NINA SKARIA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2020
Last Update Date: 08/27/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1991 MARCUS AVE
NEW HYDE PARK NY
11042-2057
US

IV. Provider business mailing address

1991 MARCUS AVE
NEW HYDE PARK NY
11042-2057
US

V. Phone/Fax

Practice location:
  • Phone: 516-472-3700
  • Fax:
Mailing address:
  • Phone: 516-472-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number383182
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: