MEDICARE: ALICIA SKOWRONSKI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	310843	NY

General Provider Information

NPI Number	:	1780046201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA SKOWRONSKI

Provider Business Mailing Address
First Line	:	30 FIRST AVE
Second Line	:
City	:	MONROE
State	:	NY
Zip	:	10950-2060
Country	:	US
Telephone Number	:	845-492-6046
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 FIRST AVE
Second Line	:
City	:	MONROE
State	:	NY
Zip	:	10950-2060
Country	:	US
Telephone Number	:	845-492-6046
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2016
Last Update Date	:	03/23/2016

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Directions to “ ALICIA SKOWRONSKI ” Practice Location

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