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General NPI Number Information
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NPI Number | 1780816637
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Entity Type | Individual
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Provider Name | ADINA SUKALIC P.A. -C
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Gender | Female
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Dates
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Enumeration Date | 08/11/2009
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 34 W 22ND ST FL 2
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City | NEW YORK
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State | NY
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Zip | 10010-7085
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Country | US
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Telephone | 646-906-8003
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Fax |
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Provider Business Mailing Address
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Address Line | 34 W 22ND ST FL 2
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City | NEW YORK
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State | NY
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Zip | 10010-7085
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Country | US
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Telephone | 646-906-8003
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00254200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 013409
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 013409
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License Number State | NY
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