Provider Demographics
NPI:1013012822
Name:SKALSKI, ARTHUR H (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:H
Last Name:SKALSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 HAZARD AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-4584
Mailing Address - Country:US
Mailing Address - Phone:860-698-9700
Mailing Address - Fax:
Practice Address - Street 1:151 HAZARD AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-4584
Practice Address - Country:US
Practice Address - Phone:860-698-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT041105207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT00141105800Medicaid
CT00141105800Medicaid
CT110008894Medicare ID - Type Unspecified