Provider Demographics
NPI:1740493634
Name:SULTAN, SAIMA (MD)
Entity type:Individual
Prefix:DR
First Name:SAIMA
Middle Name:
Last Name:SULTAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 EWING AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-2929
Mailing Address - Country:US
Mailing Address - Phone:212-342-9200
Mailing Address - Fax:201-621-6165
Practice Address - Street 1:515 AUDUBON AVE
Practice Address - Street 2:ISABELLA GERIATRIC CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-3403
Practice Address - Country:US
Practice Address - Phone:212-342-9200
Practice Address - Fax:201-621-6165
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY246658207R00000X, 207RH0002X, 208VP0000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03317140Medicaid