Provider Demographics
NPI:1578830584
Name:DARIEN PEDIATRIC ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DARIEN PEDIATRIC ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D./OWNER-PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:N
Authorized Official - Last Name:SUCHENSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-655-9741
Mailing Address - Street 1:106 NOROTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820
Mailing Address - Country:US
Mailing Address - Phone:203-655-9741
Mailing Address - Fax:203-655-9249
Practice Address - Street 1:106 NOROTON AVENUE
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820
Practice Address - Country:US
Practice Address - Phone:203-655-9741
Practice Address - Fax:203-655-9249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-18
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12967208000000X
CT027977208000000X
CT029906208000000X
CT040425208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty