MEDICARE: DR. TROY SUKKARIEH MD

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	208800000X	Urology Physician	MA080548	NJ
2	208800000X	Urology Physician	25MA08054800	NJ

General Provider Information

NPI Number	:	1003913815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TROY SUKKARIEH MD

Provider Business Mailing Address
First Line	:	1 DIAMOND HILL RD
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-2104
Country	:	US
Telephone Number	:	908-273-4300
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 IRON BRIDGE RD STE 5
Second Line	:
City	:	FREEHOLD
State	:	NJ
Zip	:	07728-5305
Country	:	US
Telephone Number	:	732-780-7603
Fax Number	:	732-308-3323

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	03/10/2022

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