Healthcare Provider Details

I. General information

NPI: 1073669255
Provider Name (Legal Business Name): ELAINE SKAWSKI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 HOSPITAL DR SUITE 303
HOLYOKE MA
01040-6603
US

IV. Provider business mailing address

199 COLLEGE HWY
SOUTHAMPTON MA
01073-9651
US

V. Phone/Fax

Practice location:
  • Phone: 413-539-6830
  • Fax: 413-538-6003
Mailing address:
  • Phone: 413-529-0118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number202154
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: