1487789392 NPI number — SKILLS UNLIMITED, INC.

Table of content: (NPI 1487789392)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487789392 NPI number — SKILLS UNLIMITED, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SKILLS UNLIMITED, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487789392
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
191 SWEET HOLLOW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OLD BETHPAGE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11804
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-870-1600
Provider Business Mailing Address Fax Number:
516-870-7060

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
405 LOCUST AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKDALE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11769-1651
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-870-1600
Provider Business Practice Location Address Fax Number:
516-870-7060
Provider Enumeration Date:
02/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BUDD
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
516-870-1600

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X , with the licence number:  6868003A , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM0850X , with the licence number: 6868-110A , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1073535902 . This is a "NPI - VEENA KULKARNI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1841213618 . This is a "NPI - LES WEINBERG" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: N3J1904091 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00468759 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1922169390 . This is a "NPI - HAROLD SEQUEIRA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 070491-1 . This is a "LICENSE - LISA GATTI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1386717460 . This is a "NPI - JANINE FIORELLO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02168532 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1164557500 . This is a "NPI - DARYL GORELIK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: W04091 . This is a "MEDICARE PTAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01494339 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02702023 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1194890608 . This is a "NPI - LISA GATTI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1720113137 . This is a "NPI - COLLEEN VATALARO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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