MEDICARE: DAVOR SKARICIC

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	2080P0203X	Pediatric Critical Care Medicine Physician	231384	NY

General Provider Information

NPI Number	:	1407059074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVOR SKARICIC

Provider Business Mailing Address
First Line	:	500 E 77TH ST APT 709
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10162-0014
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	451 CLARKSON AVE
Second Line	:	B-6202 PEDIATRICS
City	:	BROOKLYN
State	:	NY
Zip	:	11203-2057
Country	:	US
Telephone Number	:	718-245-4105
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	07/08/2007

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Directions to “ DAVOR SKARICIC ” Practice Location

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