Provider Demographics
NPI:1356341028
Name:SKINNER, PATRICIA C (PA)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:C
Last Name:SKINNER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16438-1460
Mailing Address - Country:US
Mailing Address - Phone:814-438-8195
Mailing Address - Fax:814-877-6093
Practice Address - Street 1:201 STATE ST
Practice Address - Street 2:HAMOT EMERGENCY DEPT
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16550-0002
Practice Address - Country:US
Practice Address - Phone:814-877-6139
Practice Address - Fax:814-877-6093
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001896L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
090003Medicare ID - Type Unspecified
P24411Medicare UPIN