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NPI Code Detail

MEDICARE: DAVID M SUHOCKI PA

MEDICARE: DAVID M SUHOCKI PA
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
1363AM0700XMedical Physician Assistant001103CT

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00087222OTHERCTRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12V4549OTHERCOHEALTHNET
2290001103CT02OTHERCTANTHEM BLUE CROSS
400422108200OTHERCTBLUE CARE FAMILY PLAN
5011030OTHERCTCONNECTICARE
6275591OTHERCOWELLCARE

General Provider Information

NPI Number : 1861483414
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID M SUHOCKI PA
Provider Business Mailing Address
First Line : 464 WOLCOTT RD
Second Line :
City : WOLCOTT
State : CT
Zip : 06716-2626
Country : US
Telephone Number : 203-879-6171
Fax Number : 203-879-1191
Provider Business Practice Location Address
First Line : 464 WOLCOTT RD
Second Line :
City : WOLCOTT
State : CT
Zip : 06716-2626
Country : US
Telephone Number : 203-879-6171
Fax Number : 203-879-1191
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 08/12/2013

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Directions to “ DAVID M SUHOCKI PA” Practice Location

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