Suzy Shukovsky, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

030584 Issued in CT

Practice address

365 Montauk Ave
New London, CT 06320-4700

Phone

(330) 493-4443

Fax

(330) 493-8677

NPI assigned

Nov 22, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clinic 21 of Connecticut LLC

  • Emergency Medicine Physician
  • Stamford, CT
  • NPI 1760856306
  NPD (past)
• Usacs of Connecticut, LLC

  • Emergency Medicine Physician
  • Bristol, CT
  • NPI 1285713099
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1184799439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "330-493-4443",
            "fax_number": "330-493-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204700",
            "telephone_number": "330-493-4443",
            "fax_number": "330-493-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKOVSKY",
        "first_name": "SUZY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "030584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shoreline Medical Supply, LLC
• Shoreline Periodontics, PC
• Shoreline Pulmonary Associates LLC
• Shri Kris Verma MD
• Shri Verma MD Gastroenterology LLC
• Waleed Tariq Siddiqui, MD
• Brooke H Sikora, PA-C
• Rhett Silver, MD
• Jennifer L Silvia, DPT
• Jeffrey A Simpson, MD

• Internal Medicine Physician in New London, CT
• Providers in New London, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.