Healthcare Provider Details

I. General information

NPI: 1073674917
Provider Name (Legal Business Name): CHRISTOPHER SKOK PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 W MAIN ST
FREEHOLD NJ
07728-2537
US

IV. Provider business mailing address

408 WASHINGTON AVE
SOUTH AMBOY NJ
08879-1626
US

V. Phone/Fax

Practice location:
  • Phone: 732-294-2701
  • Fax: 732-294-2568
Mailing address:
  • Phone: 732-952-2627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01028900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: