Provider Demographics
NPI:1366553810
Name:SKLAROFF, HERSCHEL JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:HERSCHEL
Middle Name:JOSEPH
Last Name:SKLAROFF
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 1:1158 FIFTH AVENUE
Mailing Address - Street 2:# LB
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-289-6500
Mailing Address - Fax:212-996-5042
Practice Address - Street 1:1158 FIFTH AVENUE
Practice Address - Street 2:# 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-289-6500
Practice Address - Fax:212-996-5042
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092399207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
0017723OtherGHI
NS2966OtherOXFORD
0017723OtherGHI
NS2966OtherOXFORD