Provider Demographics
NPI:1114961521
Name:CHESTER, SUZANNE STAMANT (DC)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:STAMANT
Last Name:CHESTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:SUZANNE
Other - Middle Name:
Other - Last Name:ST.AMANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:81 HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:WEATOGUE
Mailing Address - State:CT
Mailing Address - Zip Code:06089-9669
Mailing Address - Country:US
Mailing Address - Phone:860-651-7387
Mailing Address - Fax:
Practice Address - Street 1:720 HOPMEADOW ST
Practice Address - Street 2:SUITE 6
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070-2224
Practice Address - Country:US
Practice Address - Phone:860-658-0372
Practice Address - Fax:860-658-0076
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001243111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT88001243001OtherCIGNA
CT2449179OtherAETNA
CT2204240OtherUNITED HEALTH CARE
CT050001243CT05OtherANTHEM BLUE CROSS/SHIELD
CTU71820Medicare UPIN