Skutelsky, Marina

Skutelsky, Marina is an individual health care provider with primary practice located at 9229 Queens Blvd Suite 1E, Rego Park NY 11374-1056. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Skutelsky, Marina can be contacted via phone (718) 268-8225.

Contact Information

Primary practice address
9229 Queens Blvd Suite 1E Rego Park NY 11374-1056
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 033533 New York

Profile Details

NPI number 1750371464
LBN Legal business name Skutelsky, Marina
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750371464 NPPES
New York MEDICAID 00284006

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