Provider Demographics
NPI:1790516656
Name:SKUPINSKI, RONALD L
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:L
Last Name:SKUPINSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15600 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:OH
Mailing Address - Zip Code:44044-9019
Mailing Address - Country:US
Mailing Address - Phone:216-410-1437
Mailing Address - Fax:
Practice Address - Street 1:15600 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:OH
Practice Address - Zip Code:44044-9019
Practice Address - Country:US
Practice Address - Phone:216-410-1437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health