Provider Demographics
NPI:1295339356
Name:SUCIC, NICHOLAS THOMAS JR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:THOMAS
Last Name:SUCIC
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8525 FRANKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19136-2444
Mailing Address - Country:US
Mailing Address - Phone:215-331-9762
Mailing Address - Fax:215-331-1249
Practice Address - Street 1:8525 FRANKFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19136-2444
Practice Address - Country:US
Practice Address - Phone:215-331-9762
Practice Address - Fax:215-331-1249
Is Sole Proprietor?:No
Enumeration Date:2020-11-29
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440051183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist