Provider Demographics
NPI:1275581506
Name:SULIS, MARIA LUISA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA LUISA
Middle Name:
Last Name:SULIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1275 YORK AVE # H-1407
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6007
Mailing Address - Country:US
Mailing Address - Phone:221-639-5175
Mailing Address - Fax:212-544-1974
Practice Address - Street 1:1275 YORK AVE # H-1407
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6007
Practice Address - Country:US
Practice Address - Phone:221-639-5175
Practice Address - Fax:929-321-7097
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2503972080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02376465Medicaid
NY02376465Medicaid
NY5Z7631Medicare ID - Type Unspecified