Healthcare Provider Details

I. General information

NPI: 1124642244
Provider Name (Legal Business Name): GABRIELLA SKORUPSKI AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2020
Last Update Date: 05/04/2025
Certification Date: 05/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4740 KINGSWAY DR # 33
INDIANAPOLIS IN
46205-1521
US

IV. Provider business mailing address

4740 KINGSWAY DR # 33
INDIANAPOLIS IN
46205-1521
US

V. Phone/Fax

Practice location:
  • Phone: 317-828-0211
  • Fax:
Mailing address:
  • Phone: 317-828-0211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: