Provider Demographics
NPI:1902882467
Name:SKRBA, MACKENZIE JAMES (HS)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:JAMES
Last Name:SKRBA
Suffix:
Gender:M
Credentials:HS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USCG HQ, COMDT 2100 2ND STREET
Mailing Address - Street 2:RM 5314
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20593-3154
Mailing Address - Country:US
Mailing Address - Phone:508-968-6572
Mailing Address - Fax:
Practice Address - Street 1:USCG HQ, COMDT 2100 2ND STREET
Practice Address - Street 2:RM 5314
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593-3154
Practice Address - Country:US
Practice Address - Phone:508-968-6572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other