Sukoenig, Mark Richard
Sukoenig, Mark Richard is an individual health care provider with primary practice located at 9537 Destinyusa Drive , Syracuse NY 13204-9501. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Low Vision Rehabilitation. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Sukoenig, Mark Richard can be contacted via phone (315) 474-8490.Contact Information
Primary practice address
9537 Destinyusa Drive
Syracuse NY 13204-9501
Phone: (315) 474-8490
Fax: (315) 474-8676
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | TU003680-1 | New York |
| Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | TU003680-1 | New York |
| Eye and Vision Services Providers / Optometrist | 152W00000X | TUV003680 | New York |
Profile Details
| NPI number | 1407848724 |
|---|---|
| LBN Legal business name | Sukoenig, Mark Richard |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 23rd, 2005 |
| Last updated | Apr 14th, 2016 - about 8 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 | 1407848724 | NPPES |
| New York | Other | TU003680-1 | NY OPTOMETRY LICENSE # |
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