Provider Demographics
NPI:1477618866
Name:AWAN, RABIA SULTANA (MD)
Entity Type:Individual
Prefix:DR
First Name:RABIA
Middle Name:SULTANA
Last Name:AWAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 ROXY AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1939
Mailing Address - Country:US
Mailing Address - Phone:908-420-4429
Mailing Address - Fax:
Practice Address - Street 1:201 LYONS AVE STE D-3
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112
Practice Address - Country:US
Practice Address - Phone:973-926-8828
Practice Address - Fax:973-923-2061
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA60390207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE62549Medicare UPIN