Provider Demographics
NPI:1588816078
Name:SKERMONT, ASHLEY (MS)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:SKERMONT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:MORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1572 BARROW HL
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-9655
Mailing Address - Country:US
Mailing Address - Phone:585-315-2007
Mailing Address - Fax:
Practice Address - Street 1:1471 LONG POND RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4126
Practice Address - Country:US
Practice Address - Phone:585-723-7442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015360-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY30-0213081OtherTAX ID