Provider Demographics
NPI:1013911411
Name:SKAKALSKI, TONIA L (DO)
Entity Type:Individual
Prefix:
First Name:TONIA
Middle Name:L
Last Name:SKAKALSKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TONIA
Other - Middle Name:L
Other - Last Name:KOSEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:100 SHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1503
Mailing Address - Country:US
Mailing Address - Phone:724-981-4434
Mailing Address - Fax:724-981-3736
Practice Address - Street 1:63 PITT ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-2102
Practice Address - Country:US
Practice Address - Phone:724-981-4434
Practice Address - Fax:724-981-3736
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013213207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013091710004Medicaid
OH0203683Medicaid