Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Cloudlake Dermatology PLLC

Organization Dermatology Physician · NPI 1083164354

Cloudlake Dermatology PLLC is a Dermatology Physician in Jericho, New York. Licensed in New York. Registered with an NPI since 2016.

Licensed in
NY
In the registry since
2016
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

400 N Broadway
Jericho, NY 11753-2113
Phone: (516) 992-6350
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 263656-1 (NY)

Record details

NPI number1083164354
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sarika Banker — Owner · (516) 992-6350
NPI enumeratedOctober 10, 2016
Last updated in NPPESNovember 20, 2017
Mailing address400 N Broadway, Jericho, NY 11753-2113

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