Provider Demographics
NPI:1598377434
Name:SULTANA, AFSANA (PHARMD)
Entity Type:Individual
Prefix:
First Name:AFSANA
Middle Name:
Last Name:SULTANA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2713 MCINTOSH ST
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11369-1950
Mailing Address - Country:US
Mailing Address - Phone:516-710-4431
Mailing Address - Fax:
Practice Address - Street 1:2713 MCINTOSH ST
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11369-1950
Practice Address - Country:US
Practice Address - Phone:516-710-4431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064837183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist