Provider Demographics
NPI:1598035180
Name:SHKLARSKI, LIAT LEA (MSW)
Entity Type:Individual
Prefix:
First Name:LIAT
Middle Name:LEA
Last Name:SHKLARSKI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1449 LEXINGTON AVE
Mailing Address - Street 2:3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-2543
Mailing Address - Country:US
Mailing Address - Phone:917-522-6602
Mailing Address - Fax:
Practice Address - Street 1:1449 LEXINGTON AVE
Practice Address - Street 2:3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-5903
Practice Address - Country:US
Practice Address - Phone:917-522-6602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-12
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082185-11041C0700X, 174400000X, 1041C0700X, 174400000X
NY088090104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No174400000XOther Service ProvidersSpecialist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker