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Individual

DR. MARK RICHARD SUKOENIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
9537 DESTINYUSA DRIVE, SYRACUSE, NY 13204-9501
(315) 474-8490
(315) 474-8676
Mailing address
9537 DESTINYUSA DRIVE, SYRACUSE, NY 13204-9501
(315) 474-8490
(315) 474-8676

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
TU003680-1
NY
152W00000X
Optometrist
Primary
TUV003680
NY
152WL0500X
Low Vision Rehabilitation Optometrist
TU003680-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
TU003680-1
NY OPTOMETRY LICENSE #
NY
Enumeration date
08/23/2005
Last updated
04/14/2016
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