Healthcare Provider Details

I. General information

NPI: 1033263421
Provider Name (Legal Business Name): DIONISSIOS A SKALIOTIS LICAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 HAWTHORNE STREET
NEW BEDFORD MA
02740
US

IV. Provider business mailing address

203 HAWTHORNE STREET
NEW BEDFORD MA
02740
US

V. Phone/Fax

Practice location:
  • Phone: 508-999-4979
  • Fax:
Mailing address:
  • Phone: 508-999-4979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number253
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: