Provider Demographics
NPI:1306864285
Name:SKARA, ANDY (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ANDY
Middle Name:
Last Name:SKARA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 GLENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:FANWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07023-1419
Mailing Address - Country:US
Mailing Address - Phone:908-889-6669
Mailing Address - Fax:973-377-2951
Practice Address - Street 1:500 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-1407
Practice Address - Country:US
Practice Address - Phone:973-377-2951
Practice Address - Fax:973-377-2951
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00869900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist