Provider Demographics
NPI:1518276682
Name:SKELLY, ERIN KATHERINE (RPA-C)
Entity Type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:KATHERINE
Last Name:SKELLY
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Gender:F
Credentials:RPA-C
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Mailing Address - Street 1:3709 ERIE BLVD E
Mailing Address - Street 2:
Mailing Address - City:DE WITT
Mailing Address - State:NY
Mailing Address - Zip Code:13214-2227
Mailing Address - Country:US
Mailing Address - Phone:315-251-2244
Mailing Address - Fax:315-251-2240
Practice Address - Street 1:3709 ERIE BLVD E
Practice Address - Street 2:
Practice Address - City:DE WITT
Practice Address - State:NY
Practice Address - Zip Code:13214-2227
Practice Address - Country:US
Practice Address - Phone:315-251-2244
Practice Address - Fax:315-251-2240
Is Sole Proprietor?:No
Enumeration Date:2010-10-06
Last Update Date:2013-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY23 014320363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant