Provider Demographics
NPI:1780639047
Name:SKOLNICK, ERIC T (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:T
Last Name:SKOLNICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:110 SOUTH BEDFORD ROAD
Mailing Address - Street 2:BEDFORD ANESTHESIA, PLLC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549
Mailing Address - Country:US
Mailing Address - Phone:914-244-6787
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:34 SOUTH BEDFORD ROAD
Practice Address - Street 2:BEDFORD ANESTHESIA, PLLC
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549
Practice Address - Country:US
Practice Address - Phone:914-244-6789
Practice Address - Fax:914-242-1516
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY152759207L00000X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY79F581Medicare PIN
NY79F58LM261Medicare PIN
NYF30405Medicare UPIN