Healthcare Provider Details

I. General information

NPI: 1275564619
Provider Name (Legal Business Name): NEIL S SKOLNIK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 01/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 YORK RD STE 108
JENKINTOWN PA
19046-2852
US

IV. Provider business mailing address

500 YORK RD STE 108
JENKINTOWN PA
19046-2852
US

V. Phone/Fax

Practice location:
  • Phone: 215-481-2725
  • Fax: 215-481-3013
Mailing address:
  • Phone: 215-481-2725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD035205E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: