Provider Demographics
NPI:1548749534
Name:SOLAIMAN, FAHAD R
Entity Type:Individual
Prefix:
First Name:FAHAD
Middle Name:R
Last Name:SOLAIMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3718 73RD ST FL 5
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6265
Mailing Address - Country:US
Mailing Address - Phone:347-393-8504
Mailing Address - Fax:
Practice Address - Street 1:3718 73RD ST FL 5
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6265
Practice Address - Country:US
Practice Address - Phone:347-393-8504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care