Most Relevant Information
Provider Data
| NPI Number: | 1003562992 |
| Provider Name: | MICAH SUCKOW |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/01/2022 |
| Last Updated: | 03/01/2022 |
Provider Practice Location
7081 MAPLE RD
AKRON
NY
140019624
Practice Location Phone/Fax
| Phone: | 7165726448 |
| Fax: |
Provider Mailing Location
7081 MAPLE RD
AKRON
NY
140019624
Provider Mailing Phone/Fax
| Phone: | 7165726448 |
| Fax: |