Provider Demographics
NPI:1740444975
Name:SULTANI DELGIODICE, ATTEFA (OD FAAO)
Entity type:Individual
Prefix:DR
First Name:ATTEFA
Middle Name:
Last Name:SULTANI DELGIODICE
Suffix:
Gender:F
Credentials:OD FAAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 ALDER DR
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2307
Mailing Address - Country:US
Mailing Address - Phone:917-495-6832
Mailing Address - Fax:
Practice Address - Street 1:1033 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3517
Practice Address - Country:US
Practice Address - Phone:973-472-6405
Practice Address - Fax:973-472-4835
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007332152W00000X
NJ27OA00624400152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03162618Medicaid
NY0400006884Medicare NSC