Provider Demographics
NPI:1528042777
Name:SKOKAN, STEPHEN J (DPM)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:J
Last Name:SKOKAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1364 ROUTE 72 W
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2485
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1364 ROUTE 72 W
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2485
Practice Address - Country:US
Practice Address - Phone:609-597-3416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00229400213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ78022234623410OtherBCBS FEDERAL EMPLOYEE PGM
NJP00242007OtherRAILROAD MEDICARE
NJ1358751OtherUNITEDHEALTHCARE
NJ3835964OtherCIGNA
NJP2695772OtherOXFORD HEALTH PLANS
NJ1358751OtherUNITEDHEALTHCARE
NJ78022234623410OtherBCBS FEDERAL EMPLOYEE PGM
NJ797025Medicare ID - Type Unspecified