Individual
DR. STANLEY ROBERTS SKONIECZKI III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 E MOUNTAIN DR, WILKES BARRE, PA 18711-0027
(570) 808-7762
(570) 808-6128
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD050672L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015972990010
—
PA
01
—
10936602
CAQH
PA
Enumeration date
02/17/2006
Last updated
10/26/2022
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