Provider Demographics
NPI:1538321435
Name:STONE, SKYLAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SKYLAR
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-3232
Mailing Address - Country:US
Mailing Address - Phone:718-810-1114
Mailing Address - Fax:
Practice Address - Street 1:20214 45TH AVE FL 1
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2540
Practice Address - Country:US
Practice Address - Phone:718-283-4567
Practice Address - Fax:718-228-6882
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2024-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258171207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03601838Medicaid