Individual
MR. SERGEY SKLAROV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
421 PARK PL, SUITE 1-C, FORT LEE, NJ 07024-3735
(201) 290-6573
Mailing address
421 PARK PL, SUITE 1-C, FORT LEE, NJ 07024-3735
(201) 290-6573
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT00327300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P3664355
OXFORD CAM PROVIDER
NJ
01
—
SS1049462
ASHN PROVIDER.
NJ
Enumeration date
07/08/2006
Last updated
01/25/2013
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