Provider Demographics
NPI:1801932611
Name:SULIKOWSKI, GEORGE PAUL (DC)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:PAUL
Last Name:SULIKOWSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 HALL HILL RD
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:CT
Mailing Address - Zip Code:06071-1418
Mailing Address - Country:US
Mailing Address - Phone:860-749-0220
Mailing Address - Fax:860-763-4940
Practice Address - Street 1:227 HALL HILL RD
Practice Address - Street 2:
Practice Address - City:SOMERS
Practice Address - State:CT
Practice Address - Zip Code:06071-1418
Practice Address - Country:US
Practice Address - Phone:860-749-0220
Practice Address - Fax:860-763-4940
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000576111N00000X
MA1082111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT050000576CT02OtherBLUEBLUE SHIELD PROVIDER