Provider Demographics
NPI:1952860264
Name:SULEIMAN, KHALED H (PHARMD)
Entity Type:Individual
Prefix:
First Name:KHALED
Middle Name:H
Last Name:SULEIMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 LONG POND RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-1123
Mailing Address - Country:US
Mailing Address - Phone:585-709-0696
Mailing Address - Fax:
Practice Address - Street 1:20 PIERCES RD APT 23
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3238
Practice Address - Country:US
Practice Address - Phone:585-709-0696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-16
Last Update Date:2019-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY065006183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist