MEDICARE: CLOUDLAKE DERMATOLOGY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	263656-1	NY

General Provider Information

NPI Number	:	1083164354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLOUDLAKE DERMATOLOGY PLLC

Provider Business Mailing Address
First Line	:	400 N BROADWAY
Second Line	:
City	:	JERICHO
State	:	NY
Zip	:	11753-2113
Country	:	US
Telephone Number	:	516-992-6350
Fax Number	:	516-992-6346

Provider Business Practice Location Address
First Line	:	400 N BROADWAY
Second Line	:
City	:	JERICHO
State	:	NY
Zip	:	11753-2113
Country	:	US
Telephone Number	:	516-992-6350
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SARIKA BANKER
Credential	:	MD
Telephone Number	:	516-992-6350

Provider Enumeration Date	:	10/10/2016
Last Update Date	:	11/20/2017

Similar Medicare Providers

1447253000 — LOUIS OBERGH II P.T.
Practice Location Address:

400 N BROADWAY , UNIT D
JERICHO, NY
11753-2113

Practice Phone: 516-827-9446
Practice Fax:

1033251301 — JAIME PHILIP P.T.
Practice Location Address:

400 N BROADWAY , SUITE D
JERICHO, NY
11753-2113

Practice Phone: 516-827-9446
Practice Fax: 516-827-0042

1639330855 — DR. SARIKA BANKER MD
Practice Location Address:

400 N BROADWAY
JERICHO, NY
11753-2113

Practice Phone: 516-992-6350
Practice Fax: 516-992-6346

1679862171 — MR. KUNAL SAGGAR DDS
Practice Location Address:

400 N BROADWAY
JERICHO, NY
11753-2113

Practice Phone: 516-992-6340
Practice Fax:

1376812768 — DR. BYEONG C CHOI P.C
Practice Location Address:

400 N BROADWAY , #B
JERICHO, NY
11753-2113

Practice Phone: 516-433-4440
Practice Fax: 516-433-4440

1225419047 — DR. VISHAL SAGGAR M.D.
Practice Location Address:

400 N BROADWAY
JERICHO, NY
11753-2113

Practice Phone: 516-992-6350
Practice Fax:

Directions to “CLOUDLAKE DERMATOLOGY PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.