Provider Demographics
NPI:1174704928
Name:THAKKAR, SUCHITA K (OD)
Entity type:Individual
Prefix:DR
First Name:SUCHITA
Middle Name:K
Last Name:THAKKAR
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:2921 ERIE BLVD E
Mailing Address - Street 2:OPTOMETRIC PROVIDERS OF RHODE ISLAND, INC
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224-1430
Mailing Address - Country:US
Mailing Address - Phone:315-446-3145
Mailing Address - Fax:315-445-7675
Practice Address - Street 1:1875 MINERAL SPRING AVE
Practice Address - Street 2:OPTOMETRIC PROVIDERS OF RHODE ISLAND, INC
Practice Address - City:N PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-3719
Practice Address - Country:US
Practice Address - Phone:401-353-3200
Practice Address - Fax:401-353-4010
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RIODTA00535152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist