Provider Demographics
NPI:1689812075
Name:SKOMPINSKI, EVA T (NP)
Entity Type:Individual
Prefix:MRS
First Name:EVA
Middle Name:T
Last Name:SKOMPINSKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8294 HUNTERS CV
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4175
Mailing Address - Country:US
Mailing Address - Phone:716-633-3459
Mailing Address - Fax:
Practice Address - Street 1:2671 HARLEM RD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-4019
Practice Address - Country:US
Practice Address - Phone:716-892-9670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304869363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health