Provider Demographics
NPI:1366514325
Name:SKLANSKY, BERNARD DONALD (MD)
Entity type:Individual
Prefix:
First Name:BERNARD
Middle Name:DONALD
Last Name:SKLANSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 NORTHERN BLVD
Mailing Address - Street 2:SUITE 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:SUITE 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
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1268452086S0122X
FLME946032086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
2146213OtherAETNA
NY2616F1OtherEMPIRE BC/BS
802795OtherAFFORDABLE
AA45736OtherMDNY
38L671OtherBLUE CROSS BLUE SHIELD
CIGNAOther0794605009
AS774OtherOXFORD
CIGNAOther0794605009
NY38L671Medicare PIN