Provider Demographics
NPI:1184971558
Name:SKR MEDICAL ADVISORS
Entity type:Organization
Organization Name:SKR MEDICAL ADVISORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SATISH
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-523-9505
Mailing Address - Street 1:560 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-1532
Mailing Address - Country:US
Mailing Address - Phone:201-345-3839
Mailing Address - Fax:201-345-4536
Practice Address - Street 1:560 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071-1532
Practice Address - Country:US
Practice Address - Phone:201-345-3839
Practice Address - Fax:201-345-4536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-05
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09104500261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
I58903Medicare UPIN