=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750998720
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TERESA MARIE SKYBAN PT, DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/24/2020
-----------------------------------------------------
Last Update Date | 08/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 233 E KING ST STE 103
-----------------------------------------------------
City | MALVERN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19355-2574
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 484-318-7241
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10 RITTENHOUSE CT
-----------------------------------------------------
City | CHESTERBROOK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19087-1216
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-373-0845
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT031979
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------