Provider Demographics
NPI:1073600664
Name:SCHIKMAN, LANA (DOPM)
Entity Type:Individual
Prefix:DR
First Name:LANA
Middle Name:
Last Name:SCHIKMAN
Suffix:
Gender:F
Credentials:DOPM
Other - Prefix:MRS
Other - First Name:LUBOV
Other - Middle Name:
Other - Last Name:CHIKVASHVILI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11011 QUEENS BLVD APT 21M
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5408
Mailing Address - Country:US
Mailing Address - Phone:718-544-3171
Mailing Address - Fax:516-921-2530
Practice Address - Street 1:11960 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-2606
Practice Address - Country:US
Practice Address - Phone:718-441-0908
Practice Address - Fax:718-441-0793
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006176-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02848084Medicaid
NY07909Medicare PIN
NYV11002Medicare UPIN