Provider Demographics
NPI:1649478074
Name:CRAIG A SKOLNICK MD PA
Entity type:Organization
Organization Name:CRAIG A SKOLNICK MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:A
Authorized Official - Last Name:SKOLNICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-254-1527
Mailing Address - Street 1:641 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-2791
Mailing Address - Country:US
Mailing Address - Phone:561-296-2010
Mailing Address - Fax:561-296-2001
Practice Address - Street 1:641 UNIVERSITY BLVD
Practice Address - Street 2:STE 111
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458
Practice Address - Country:US
Practice Address - Phone:561-296-2010
Practice Address - Fax:561-296-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAF689Medicare PIN