Healthcare Provider Details

I. General information

NPI: 1043882905
Provider Name (Legal Business Name): JOYCE NOREEN SKOCZYLAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2021
Last Update Date: 07/12/2021
Certification Date: 07/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 HANFORD RD
FAIRLESS HILLS PA
19030-2529
US

IV. Provider business mailing address

821 HANFORD RD
FAIRLESS HILLS PA
19030-2529
US

V. Phone/Fax

Practice location:
  • Phone: 215-704-1215
  • Fax: 267-585-3522
Mailing address:
  • Phone: 215-704-1215
  • Fax: 267-585-3522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN524696L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: