Provider Demographics
NPI:1891061230
Name:SKLAR, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SKLAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 E BROADWAY
Mailing Address - Street 2:C305
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-5670
Mailing Address - Country:US
Mailing Address - Phone:212-673-7884
Mailing Address - Fax:
Practice Address - Street 1:351 W 18TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-4402
Practice Address - Country:US
Practice Address - Phone:212-675-1913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006650-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist