Individual provider Active NPI

Maryann Skoblicki, RN

  • Registered Nurse
  • East Patchogue, NY
National Provider Identifier
1306093836
Registry record updated Aug 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
278790 Issued in NY
Practice address
92 Circle Dr W
East Patchogue, NY 11772-4294
Phone
(631) 289-3626
NPI assigned
Aug 27, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 278790 NY Primary

Addresses

Primary practice location

92 Circle Dr W
East Patchogue, NY 11772-4294

Mailing address

92 Circle Dr W
East Patchogue, NY 11772-4294
Phone (631) 289-3626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
278790NYMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219795200000",
    "number": "1306093836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 CIRCLE DR W",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724294",
            "telephone_number": "631-289-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 CIRCLE DR W",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724294",
            "telephone_number": "631-289-3626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOBLICKI",
        "first_name": "MARYANN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2008-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "278790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.