Provider Demographics
NPI:1679580948
Name:SULTANA, NAHEED (MD)
Entity type:Individual
Prefix:DR
First Name:NAHEED
Middle Name:
Last Name:SULTANA
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 1:8742 169TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-3632
Mailing Address - Country:US
Mailing Address - Phone:718-206-2222
Mailing Address - Fax:718-206-9090
Practice Address - Street 1:8742 169TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3632
Practice Address - Country:US
Practice Address - Phone:718-206-2222
Practice Address - Fax:718-206-9090
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211588207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01873541Medicaid
NY01873541Medicaid
NY03129GMedicare PIN
NY03129HMedicare PIN