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NPI Code Detail

MEDICARE: CONSTANCE SKALSKY PA-C

MEDICARE: CONSTANCE SKALSKY PA-C
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
1363A00000XPhysician Assistant50000729OH

General Provider Information

NPI Number : 1952357089
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONSTANCE SKALSKY PA-C
Provider Business Mailing Address
First Line : 451 MEADOWLANE RD
Second Line :
City : SEVEN HILLS
State : OH
Zip : 44131-6128
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 18697 BAGLEY RD
Second Line :
City : MIDDLEBURG HEIGHTS
State : OH
Zip : 44130-3417
Country : US
Telephone Number : 440-816-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2006
Last Update Date : 07/08/2007

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Directions to “ CONSTANCE SKALSKY PA-C” Practice Location

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