Provider Demographics
NPI:1780909382
Name:B DONALD SKLANSKY MD PC
Entity type:Organization
Organization Name:B DONALD SKLANSKY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:SKLANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-504-1800
Mailing Address - Street 1:833 NORTHERN BLVD
Mailing Address - Street 2:115
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5315
Mailing Address - Country:US
Mailing Address - Phone:516-504-1800
Mailing Address - Fax:516-466-7359
Practice Address - Street 1:833 NORTHERN BLVD
Practice Address - Street 2:115
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5315
Practice Address - Country:US
Practice Address - Phone:516-504-1800
Practice Address - Fax:516-466-7359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY38L671Medicare UPIN