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General NPI Number Information
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NPI Number | 1669524120
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Entity Type | Individual
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Provider Name | JAY FREDRIC SKOLNICK PSYD
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Gender | Male
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 340 E MAPLE AVE #207
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City | LANGHORNE
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State | PA
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Zip | 19047
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Country | US
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Telephone | 215-757-5869
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Fax | 215-757-2737
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Provider Business Mailing Address
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Address Line | 136 N BELLEVUE AVE
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City | LANGHORNE
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State | PA
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Zip | 19047
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Country | US
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Telephone | 215-702-8457
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PS008202L
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License Number State | PA
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