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General NPI Number Information
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NPI Number | 1821125956
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Entity Type | Organization
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Legal Business Name | AESTHETIC DERMATOLOGY, LLC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 05/13/2019
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Provider Practice Location Address
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Address Line | 800 WOODBURY RD STE A
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City | WOODBURY
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State | NY
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Zip | 11797-2503
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Country | US
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Telephone | 516-496-9400
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Fax | 516-496-9212
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Provider Business Mailing Address
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Address Line | 800 WOODBURY RD
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City | WOODBURY
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State | NY
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Zip | 11797-2503
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Country | US
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Telephone | 516-496-3400
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Fax | 516-496-9212
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY SKLAR
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Credential | MD
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Telephone | 516-496-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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