Healthcare Provider Details

I. General information

NPI: 1285838201
Provider Name (Legal Business Name): ANTHONY J SUCHOSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 05/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 GLENWAY AVE 305
CINCINNATI OH
45211-6378
US

IV. Provider business mailing address

4685 FOREST AVE STE C
CINCINNATI OH
45212-3397
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-7000
  • Fax: 513-481-4101
Mailing address:
  • Phone: 513-246-7000
  • Fax: 513-246-7852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number35.092354
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: