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General NPI Number Information
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NPI Number | 1417219593
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Entity Type | Individual
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Provider Name | MRS. SARAH JORDAN LAKE ESKIN
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Gender | Female
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Dates
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Enumeration Date | 06/13/2012
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Last Update Date | 06/13/2012
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Provider Practice Location Address
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Address Line | 116 W 32ND ST 8TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10001-3212
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Country | US
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Telephone | 917-362-6046
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Fax |
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Provider Business Mailing Address
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Address Line | 350 7TH ST APT. 4B
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City | HOBOKEN
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State | NJ
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Zip | 07030-2890
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Country | US
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Telephone | 201-683-4056
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 1698646
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License Number State | NY
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