Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | OS013213 | PA |
NPI | 1013911411 |
---|---|
Provider Name | Tonia L Skakalski |
First Address | Sharon, PA 16146-1503 |
Second Address | Sharon, PA 16146-2102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2005 |
Last Update Date | 05/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0203683 | (05) | OH |
1013091710004 | (05) | PA |