Provider Demographics
NPI:1508054107
Name:L. SKOBLE MD INC
Entity Type:Organization
Organization Name:L. SKOBLE MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SKOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-348-9947
Mailing Address - Street 1:28 DONIZETTI RD
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-4621
Mailing Address - Country:US
Mailing Address - Phone:401-348-9947
Mailing Address - Fax:401-322-9981
Practice Address - Street 1:28 DONIZETTI RD
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-4621
Practice Address - Country:US
Practice Address - Phone:401-348-9947
Practice Address - Fax:401-322-9981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD089902084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI269023713Medicare PIN