Healthcare Provider Details

I. General information

NPI: 1720168297
Provider Name (Legal Business Name): SATU M KUOKKANEN MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 CORPORATE CENTER DR SUITE 101
MELVILLE NY
11747-3193
US

IV. Provider business mailing address

22 WATERVILLE RD IN VITRO SCIENCES
AVON CT
06001-2066
US

V. Phone/Fax

Practice location:
  • Phone: 631-752-0606
  • Fax: 631-752-0623
Mailing address:
  • Phone: 860-678-3424
  • Fax: 860-284-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number236948
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number236948
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: