Provider Demographics
NPI:1033208285
Name:SUCHOFF, LAWRENCE J (DC)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:J
Last Name:SUCHOFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ILANA LN
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-1002
Mailing Address - Country:US
Mailing Address - Phone:845-362-1515
Mailing Address - Fax:845-362-1314
Practice Address - Street 1:8 ILANA LN
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-1002
Practice Address - Country:US
Practice Address - Phone:845-362-1515
Practice Address - Fax:845-362-1314
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX2467111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX13771Medicare ID - Type Unspecified