Provider Demographics
NPI:1417040627
Name:SCKELL, BLANCA M (MD)
Entity Type:Individual
Prefix:
First Name:BLANCA
Middle Name:M
Last Name:SCKELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BLANCA
Other - Middle Name:
Other - Last Name:SCKELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:18219 HORACE HARDING EXPY
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-2242
Mailing Address - Country:US
Mailing Address - Phone:212-604-3718
Mailing Address - Fax:212-604-3718
Practice Address - Street 1:18219 HORACE HARDING EXPY FL 1
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-2242
Practice Address - Country:US
Practice Address - Phone:718-670-2903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211239207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine