Provider Demographics
NPI:1992760011
Name:SKOCZYLAS, STANLEY JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:STANLEY
Middle Name:JOSEPH
Last Name:SKOCZYLAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 NANCY TERRACE
Mailing Address - Street 2:WASHINGTON TOWNSHIP
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840
Mailing Address - Country:US
Mailing Address - Phone:908-852-7100
Mailing Address - Fax:908-813-1067
Practice Address - Street 1:32 NANCY TERRACE
Practice Address - Street 2:WASHINGTON TOWNSHIP
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840
Practice Address - Country:US
Practice Address - Phone:908-852-7100
Practice Address - Fax:908-813-1067
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA31530207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1685503Medicaid
NJSK152441Medicare ID - Type Unspecified
NJ1685503Medicaid