Healthcare Provider Details

I. General information

NPI: 1144687799
Provider Name (Legal Business Name): KEVIN SKIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 NESCONSET HWY BLDG 17C
STONY BROOK NY
11790-2563
US

IV. Provider business mailing address

101 NICOLLS RD RM 20
STONY BROOK NY
11794-8101
US

V. Phone/Fax

Practice location:
  • Phone: 631-210-6305
  • Fax:
Mailing address:
  • Phone: 631-689-8333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number338119-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: