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General NPI Number Information
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NPI Number | 1790855468
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Entity Type | Individual
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Provider Name | ANDREAS SKOUNAKIS D.C.
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Gender | Male
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1011 CLIFTON AVE STE 1F
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City | CLIFTON
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State | NJ
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Zip | 07013-3518
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Country | US
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Telephone | 973-779-2466
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Fax | 973-779-4943
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Provider Business Mailing Address
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Address Line | 1011 CLIFTON AVE STE 1F
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City | CLIFTON
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State | NJ
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Zip | 07013-3518
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Country | US
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Telephone | 973-779-2466
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Fax | 973-779-4943
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | MC006118
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00611800
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License Number State | NJ
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