Provider Demographics
NPI:1184686933
Name:SUCHECKI, BRYAN THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:THOMAS
Last Name:SUCHECKI
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:65 DOUGLAS RD
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2219
Mailing Address - Country:US
Mailing Address - Phone:860-502-5679
Mailing Address - Fax:
Practice Address - Street 1:250 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7559
Practice Address - Country:US
Practice Address - Phone:603-228-1521
Practice Address - Fax:603-225-2510
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2260122085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH16984OtherNH BOARD OF MEDICINE