Healthcare Provider Details

I. General information

NPI: 1629463294
Provider Name (Legal Business Name): MATTHEW SKOBLAR D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2015
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 RARITAN RD FL 2
CLARK NJ
07066-1757
US

IV. Provider business mailing address

640 WILLOW AVE UNIT A
GARWOOD NJ
07027-1230
US

V. Phone/Fax

Practice location:
  • Phone: 732-454-8020
  • Fax:
Mailing address:
  • Phone: 201-803-3336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberOS020706
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MB11076300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: