MEDICARE: DR. LARRY ALAN SUECOF DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	000281	CT
2	213ES0103X	Foot & Ankle Surgery Podiatrist	POOOO2293	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	480000668	OTHER		MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0600211278	OTHER	CT	CONNECTICARE
2	0724234 001	OTHER	CT	CIGNA
4	06-1406459	OTHER	CT	COLONIAL COOPERATIVE CARE
5	1033104062	OTHER	CT	ANTHEM BCBS
6	2534362	OTHER	CT	AETNA
7	P4041219	OTHER	CT	OXFORD
8	06-1406459	OTHER	CT	MULTIPLAN
9	06-1406459	OTHER	CT	UNITED HEALTHCARE
10	06-1406459	OTHER	CT	FOCUS
11	0R3020	OTHER	CT	HEALTH NET
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033104062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARRY ALAN SUECOF DPM

Provider Business Mailing Address
First Line	:	5 EXETER PARK
Second Line	:
City	:	FARMINGTON
State	:	CT
Zip	:	06032-1555
Country	:	US
Telephone Number	:	407-417-7478
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 EXETER PARK
Second Line	:
City	:	FARMINGTON
State	:	CT
Zip	:	06032-1555
Country	:	US
Telephone Number	:	407-417-7478
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	04/03/2025

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