Provider Demographics
NPI:1730207796
Name:SKOLNIK, DAVID (OTR, CHT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:SKOLNIK
Suffix:
Gender:M
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2116
Mailing Address - Country:US
Mailing Address - Phone:908-654-8500
Mailing Address - Fax:908-654-1327
Practice Address - Street 1:502 E BROAD ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2116
Practice Address - Country:US
Practice Address - Phone:908-654-8500
Practice Address - Fax:908-654-1327
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00086600174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist