Provider Demographics
NPI:1467446336
Name:SKIBICKI, CHRISTY RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:RENEE
Last Name:SKIBICKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHRISTY
Other - Middle Name:RENEE
Other - Last Name:RUDDEROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3025 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4518
Mailing Address - Country:US
Mailing Address - Phone:717-691-1212
Mailing Address - Fax:717-691-5354
Practice Address - Street 1:3025 MARKET ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4518
Practice Address - Country:US
Practice Address - Phone:717-691-1212
Practice Address - Fax:717-691-5354
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD439381207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024980910Medicaid
PAP010257OtherGATEWAY-WMG
PA30088118OtherAMERIHEALTH MERCY-WMG
PA186209FLTMedicare PIN