Provider Demographics
NPI:1255922084
Name:SALTANAT MEDICAL LLC
Entity type:Organization
Organization Name:SALTANAT MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FAYSAL
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSEFI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-793-4531
Mailing Address - Street 1:3022 S DURANGO DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-4440
Mailing Address - Country:US
Mailing Address - Phone:702-256-3637
Mailing Address - Fax:
Practice Address - Street 1:3022 S DURANGO DR STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-4440
Practice Address - Country:US
Practice Address - Phone:702-256-3637
Practice Address - Fax:702-256-3307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-03
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty