Provider Demographics
NPI:1447536024
Name:SLIKER, SUZANNE EILEEN (RPH)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:EILEEN
Last Name:SLIKER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:SUZANNE
Other - Middle Name:EILEEN
Other - Last Name:COPPOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:148 SHWEKY LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-4142
Mailing Address - Country:US
Mailing Address - Phone:860-621-2624
Mailing Address - Fax:860-621-6408
Practice Address - Street 1:359 MAIN ST
Practice Address - Street 2:WALGREENS #7641
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-4538
Practice Address - Country:US
Practice Address - Phone:860-621-3729
Practice Address - Fax:860-621-6408
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7627183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist