Provider Demographics
NPI:1952387870
Name:SKLAR, STUART L (OD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:L
Last Name:SKLAR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 WATERFRONT PL
Mailing Address - Street 2:
Mailing Address - City:PORT CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10573-6001
Mailing Address - Country:US
Mailing Address - Phone:914-939-0982
Mailing Address - Fax:914-639-1041
Practice Address - Street 1:29 WATERFRONT PL
Practice Address - Street 2:
Practice Address - City:PORT CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10573-6001
Practice Address - Country:US
Practice Address - Phone:914-939-0982
Practice Address - Fax:914-639-1041
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT004947152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC 40731Medicare ID - Type Unspecified
U17991Medicare UPIN