Provider Demographics
NPI:1225279805
Name:PASKLINSKY, GARRI (MD)
Entity Type:Individual
Prefix:DR
First Name:GARRI
Middle Name:
Last Name:PASKLINSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 TERN CT
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-7529
Mailing Address - Country:US
Mailing Address - Phone:347-276-2798
Mailing Address - Fax:
Practice Address - Street 1:580 UNION BLVD
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-3105
Practice Address - Country:US
Practice Address - Phone:631-321-6801
Practice Address - Fax:631-321-3869
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256280-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400052601Medicare PIN