Healthcare Provider Details

I. General information

NPI: 1215417472
Provider Name (Legal Business Name): EMILY ELIZABETH SKONECKI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2018
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1334 BAINBRIDGE ST
PHILADELPHIA PA
19147-1810
US

IV. Provider business mailing address

2141 ROUTE 38 APT 1009
CHERRY HILL NJ
08002-4215
US

V. Phone/Fax

Practice location:
  • Phone: 215-625-7902
  • Fax: 215-625-7906
Mailing address:
  • Phone: 570-590-8457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP452509
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: