Healthcare Provider Details

I. General information

NPI: 1427952324
Provider Name (Legal Business Name): CAROL J SKUDLAREK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LEO MOSS DR
OLEAN NY
14760-1100
US

IV. Provider business mailing address

1 LEO MOSS DR
OLEAN NY
14760-1100
US

V. Phone/Fax

Practice location:
  • Phone: 716-373-8050
  • Fax: 716-701-3744
Mailing address:
  • Phone: 716-373-8050
  • Fax: 716-701-3744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number379584-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: