Healthcare Provider Details

I. General information

NPI: 1689812075
Provider Name (Legal Business Name): EVA T SKOMPINSKI N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2009
Last Update Date: 01/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2671 HARLEM RD
CHEEKTOWAGA NY
14225-4019
US

IV. Provider business mailing address

8294 HUNTERS CV
WILLIAMSVILLE NY
14221-4175
US

V. Phone/Fax

Practice location:
  • Phone: 716-892-9670
  • Fax:
Mailing address:
  • Phone: 716-633-3459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number304869
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: