Provider Demographics
NPI:1114124195
Name:SKURCENSKI, ALISON HAYES (MD)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:HAYES
Last Name:SKURCENSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 N 12TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1219
Mailing Address - Country:US
Mailing Address - Phone:717-919-1845
Mailing Address - Fax:717-296-0716
Practice Address - Street 1:645 N 12TH ST STE 300
Practice Address - Street 2:
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-1219
Practice Address - Country:US
Practice Address - Phone:717-919-1845
Practice Address - Fax:717-296-0716
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD068580-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001770957Medicaid
PA027981Medicare PIN
PA001770957Medicaid