Individual
FREDERIC P SKINNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
602 IVY ST, ELMIRA, NY 14905-1646
(607) 735-4633
(607) 735-4628
Mailing address
722 W WATER ST, ELMIRA, NY 14905-2435
(607) 271-2050
(607) 271-2099
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
134463
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00359926
—
NY
Enumeration date
10/18/2006
Last updated
07/09/2007
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