Provider Demographics
NPI:1316278831
Name:MARTINS-SKOLNY, SANDRA D
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:D
Last Name:MARTINS-SKOLNY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WILLIAMSON TERRACE
Mailing Address - Street 2:NT
Mailing Address - City:BATH
Mailing Address - State:NY
Mailing Address - Zip Code:14810
Mailing Address - Country:US
Mailing Address - Phone:607-377-1912
Mailing Address - Fax:
Practice Address - Street 1:111 WILLIAMSON TERRACE
Practice Address - Street 2:NT
Practice Address - City:BATH
Practice Address - State:NY
Practice Address - Zip Code:14810
Practice Address - Country:US
Practice Address - Phone:607-377-1912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-22
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030646-1225100000X
NY03064612251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics