=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225286198
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEVEN SKLAR, DO PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/04/2008
-----------------------------------------------------
Last Update Date | 09/18/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2701 COWPATH RD
-----------------------------------------------------
City | HATFIELD
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19440-2300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-855-2820
-----------------------------------------------------
Fax | 215-855-4439
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 339
-----------------------------------------------------
City | HATFIELD
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19440-0339
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-855-2820
-----------------------------------------------------
Fax | 215-855-4439
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | STEVEN SKLAR
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 215-855-2820
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | OS003609L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------