Healthcare Provider Details

I. General information

NPI: 1013911411
Provider Name (Legal Business Name): TONIA L SKAKALSKI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TONIA L KOSEK D.O.

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 06/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 PITT ST
SHARON PA
16146-2102
US

IV. Provider business mailing address

100 SHENANGO AVE
SHARON PA
16146-1503
US

V. Phone/Fax

Practice location:
  • Phone: 724-981-4434
  • Fax: 724-981-3736
Mailing address:
  • Phone: 724-981-4434
  • Fax: 724-981-3736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOS013213
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: