Provider Demographics
NPI:1508186909
Name:SULIAMAN, FAWZI A (MD)
Entity Type:Individual
Prefix:
First Name:FAWZI
Middle Name:A
Last Name:SULIAMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 N 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2408
Mailing Address - Country:US
Mailing Address - Phone:732-545-0094
Mailing Address - Fax:732-545-2750
Practice Address - Street 1:926 N WOOD AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-4040
Practice Address - Country:US
Practice Address - Phone:908-925-3318
Practice Address - Fax:908-925-8646
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08353900207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP4196905OtherOXFORD
NJ6325284OtherAETNA HMO
NJ9508516OtherAETNA
NJ1508186909OtherU.S. FAMILY HEALTH
NJ1750862OtherGHI
NJ650932OtherWELLCARE NJ
NJ0146653OtherAMERIGROUP
NJ5528443OtherCIGNA
NJ60105006OtherHORIZON NJ HEALTH
NJ6N6791OtherEMPIRE BC
11303OtherMAGNACARE
NJ2192317OtherCOVENTRY HEALTH
NJ3249923OtherUNITED HEALTHCARE
NJ0232963Medicaid
NJ9508516OtherAETNA