Healthcare Provider Details

I. General information

NPI: 1063545838
Provider Name (Legal Business Name): GERALD SKOBINSKY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 03/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6615 TORRESDALE AVE
PHILADELPHIA PA
19135-2827
US

IV. Provider business mailing address

6615 TORRESDALE AVE
PHILADELPHIA PA
19135-2827
US

V. Phone/Fax

Practice location:
  • Phone: 215-331-2406
  • Fax:
Mailing address:
  • Phone: 215-331-2406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberOS002823
License Number StatePA

VIII. Authorized Official

Name: DR. GERALD H SKOBINSKY
Title or Position: PHYSICIAN
Credential: DO
Phone: 215-331-2406