1861483414 NPI number — DAVID M SUHOCKI PA

Table of content: DAVID M SUHOCKI PA (NPI 1861483414)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861483414 NPI number — DAVID M SUHOCKI PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SUHOCKI
Provider First Name:
DAVID
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861483414
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/09/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4700 EXCHANGE CT STE 110
Provider Second Line Business Mailing Address:
ADVANCED DERMATOLOGY CENTER, PC
Provider Business Mailing Address City Name:
BOCA RATON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33431-4450
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-948-0291
Provider Business Mailing Address Fax Number:
561-859-0429

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
464 WOLCOTT RD STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOLCOTT
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06716-2626
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-879-6171
Provider Business Practice Location Address Fax Number:
203-879-1191
Provider Enumeration Date:
11/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  001103 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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