Provider Demographics
NPI:1760419139
Name:SUCIU, CORINA M (MD)
Entity Type:Individual
Prefix:
First Name:CORINA
Middle Name:M
Last Name:SUCIU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E MAIN ST
Mailing Address - Street 2:NORTHERN WESTCHESTER HOSPITAL-MEDICAL AFFAIRS OFFICE
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3417
Mailing Address - Country:US
Mailing Address - Phone:914-666-1680
Mailing Address - Fax:914-666-1965
Practice Address - Street 1:400 E MAIN ST
Practice Address - Street 2:NORTHERN WESTCHESTER HOSPITAL
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3417
Practice Address - Country:US
Practice Address - Phone:914-666-1680
Practice Address - Fax:914-666-1965
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240589207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
415AG1OtherEMPIRE BC-BS
0609150000006OtherFIDELIS CARE OF NY
NY1344497OtherAETNA PPO PIN
7494834OtherAETNA HMO PIN
3889919OtherMVP HEALTHPLAN
P00349190OtherRAILROAD MEDICARE PIN
10112897-U104OtherCDPHP PROVIDER ID & GRP #
3C5202OtherHEALTHNET GRP ID
10112897-U104OtherCDPHP PROVIDER ID & GRP #
3889919OtherMVP HEALTHPLAN