Provider Demographics
NPI:1225079353
Name:SULTAN, BURTON S (MD)
Entity Type:Individual
Prefix:DR
First Name:BURTON
Middle Name:S
Last Name:SULTAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:211 GUINEA WOODS RD
Mailing Address - Street 2:
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568-1523
Mailing Address - Country:US
Mailing Address - Phone:516-746-4018
Mailing Address - Fax:516-746-2536
Practice Address - Street 1:211 GUINEA WOODS RD
Practice Address - Street 2:
Practice Address - City:OLD WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11568-1523
Practice Address - Country:US
Practice Address - Phone:516-746-4018
Practice Address - Fax:516-746-2536
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY086440-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB14847Medicare UPIN
NY448792Medicare PIN