Healthcare Provider Details

I. General information

NPI: 1710177993
Provider Name (Legal Business Name): GEORGE SKOWRONSKI M.ED.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 10/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2469C LITITZ PIKE
LANCASTER PA
17601-3640
US

IV. Provider business mailing address

2469C LITITZ PIKE
LANCASTER PA
17601-3640
US

V. Phone/Fax

Practice location:
  • Phone: 717-569-7450
  • Fax:
Mailing address:
  • Phone: 717-569-7450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAT000066L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License NumberAT000066L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAT000066L
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License NumberAT000066L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: