Healthcare Provider Details

I. General information

NPI: 1154198182
Provider Name (Legal Business Name): DR MATTHEW SKOBLAR DO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2023
Last Update Date: 12/27/2023
Certification Date: 12/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 N CENTRAL AVE
RAMSEY NJ
07446-1864
US

IV. Provider business mailing address

640 WILLOW AVE UNIT A
GARWOOD NJ
07027-1230
US

V. Phone/Fax

Practice location:
  • Phone: 201-962-9066
  • Fax: 201-537-2369
Mailing address:
  • Phone: 201-803-3336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW SKOBLAR
Title or Position: PHYSICIAN
Credential: DO
Phone: 201-803-3336