Provider Demographics
NPI:1265515035
Name:SUKOFF, LIBBY I (OD)
Entity type:Individual
Prefix:DR
First Name:LIBBY
Middle Name:I
Last Name:SUKOFF
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2589 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4552
Mailing Address - Country:US
Mailing Address - Phone:718-332-3596
Mailing Address - Fax:718-769-3296
Practice Address - Street 1:2589 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4552
Practice Address - Country:US
Practice Address - Phone:718-332-3596
Practice Address - Fax:718-769-3296
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT002460152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC99092Medicare ID - Type Unspecified
NY36246Medicare UPIN