Provider Demographics
NPI:1396954442
Name:SKARBEK, GREGORY STEPHEN (OTR)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:STEPHEN
Last Name:SKARBEK
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3618 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:PUNXSUTAWNEY
Mailing Address - State:PA
Mailing Address - Zip Code:15767-9764
Mailing Address - Country:US
Mailing Address - Phone:814-938-3818
Mailing Address - Fax:
Practice Address - Street 1:3618 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-9764
Practice Address - Country:US
Practice Address - Phone:814-938-3818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008100225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01887655Medicaid