Provider Demographics
NPI:1932155975
Name:SUCHAK, NIHARIKA NARESH (MD)
Entity Type:Individual
Prefix:
First Name:NIHARIKA
Middle Name:NARESH
Last Name:SUCHAK
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 1:1115 W CALL ST STE 4300
Mailing Address - Street 2:FLORIDA STATE UNIVERSITY - COLLEGE OF MEDICINE
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32306-4300
Mailing Address - Country:US
Mailing Address - Phone:850-644-2372
Mailing Address - Fax:
Practice Address - Street 1:4449 MEANDERING WAY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5740
Practice Address - Country:US
Practice Address - Phone:850-644-2372
Practice Address - Fax:850-645-2824
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME110050207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8850909Medicaid
G43938Medicare UPIN
NJ8850909Medicaid