MEDICARE: AMY SKLAR

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	225X00000X	Occupational Therapist	006650-1	NY

General Provider Information

NPI Number	:	1891061230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY SKLAR

Provider Business Mailing Address
First Line	:	264 E BROADWAY
Second Line	:	C305
City	:	NEW YORK
State	:	NY
Zip	:	10002-5670
Country	:	US
Telephone Number	:	212-673-7884
Fax Number	:

Provider Business Practice Location Address
First Line	:	351 W 18TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011-4402
Country	:	US
Telephone Number	:	212-675-1913
Fax Number	:

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

Provider Enumeration Date	:	03/29/2012
Last Update Date	:	03/29/2012

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