Provider Demographics
NPI:1427878883
Name:SKUTELSKY, ALENA (NP)
Entity type:Individual
Prefix:
First Name:ALENA
Middle Name:
Last Name:SKUTELSKY
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 POCONO RD STE 110
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2905
Mailing Address - Country:US
Mailing Address - Phone:973-586-3700
Mailing Address - Fax:973-586-8666
Practice Address - Street 1:16 POCONO RD STE 110
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2905
Practice Address - Country:US
Practice Address - Phone:973-586-3700
Practice Address - Fax:973-586-8666
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-11
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15194300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily