Healthcare Provider Details

I. General information

NPI: 1780689950
Provider Name (Legal Business Name): J. SKLAR COMPUTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1096 STRATHMORE ST
VALLEY STREAM NY
11581-2837
US

IV. Provider business mailing address

1096 STRATHMORE ST
VALLEY STREAM NY
11581-2837
US

V. Phone/Fax

Practice location:
  • Phone: 516-791-5630
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTUV 4190
License Number StateNY

VIII. Authorized Official

Name: DR. JOEL F SKLAR
Title or Position: PRESIDENT
Credential:
Phone: 516-791-5630