National Provider Identifier

Amy E Sucheski-Drake, MD

Amy E Sucheski-Drake, MD is listed in the NPPES registry with a primary specialty of Sports Medicine (Family Medicine) Physician in Ithaca, NY and a listed phone number of (607) 255-5155.

NPI 1780752634Ithaca, NYSports Medicine (Family Medicine) Physician

Profile Overview

NPI
1780752634
Provider Type
Individual
Primary Specialty
Sports Medicine (Family Medicine) Physician
Enumeration Date
November 30, 2006
Last Updated
June 21, 2021

Practice Location

  • 110 Ho Plz
  • Ithaca, NY 14853-3102

Phone: (607) 255-5155

Specialties

  • Sports Medicine (Family Medicine) Physician (207QS0010X)
  • Sports Medicine (Family Medicine) Physician (207QS0010X)
Full Record
NPI
1780752634
Entity Type
Individual
Last Name
Sucheski-Drake
First Name
Amy
Middle Name
E
Credential
MD
Provider Other Last Name
Sucheski
Provider Other First Name
Amy
Provider Other Middle Name
E
Provider Other Credential Text
MD
Provider Other Last Name Type Code
1
Mailing Street Address
110 Ho Plz
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14853-3102
Mailing Country
US
Mailing Phone
(607) 255-5155
Practice Street Address
110 Ho Plz
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14853-3102
Practice Country
US
Practice Phone
(607) 255-5155
Enumeration Date
November 30, 2006
Last Updated
June 21, 2021
Sex
Female
Sole Proprietor
No
Certification Date
June 21, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Sports Medicine (Family Medicine) Physician (207QS0010X), Sports Medicine (Family Medicine) Physician (207QS0010X)
Other Identifiers
30209644 (NH)