Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | MA080548 | NJ |
NPI | 1003913815 |
---|---|
Provider Name | Dr. Troy Sukkarieh |
First Address | Morganville, NJ 07751-1563 |
Second Address | Morganville, NJ 07751-1563 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 30/06/2021 |