Kostka-Suvelza, Marcia
Kostka-Suvelza, Marcia is an sole proprietor health care provider with primary practice located at 604 I St , La Porte IN 46350-5530. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Kostka-Suvelza, Marcia can be contacted via phone (219) 326-8855.Contact Information
Primary practice address
604 I St
La Porte IN 46350-5530
Phone: (219) 326-8855
Fax: (219) 326-8835
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 18002824 | Indiana |
Profile Details
| NPI number | 1811972680 |
|---|---|
| LBN Legal business name | Kostka-Suvelza, Marcia |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 14th, 2005 |
| Last updated | Aug 29th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811972680 | NPPES |
| Indiana | MEDICAID | 200108470A |
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