Provider Demographics
NPI:1386863702
Name:SOUD, SULEIMAN TSAWAT (CNA)
Entity type:Individual
Prefix:MR
First Name:SULEIMAN
Middle Name:TSAWAT
Last Name:SOUD
Suffix:
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4014 ARCTIC AVENUE
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08260
Mailing Address - Country:US
Mailing Address - Phone:609-972-1070
Mailing Address - Fax:
Practice Address - Street 1:4014 ARCTIC AVE
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08260-1925
Practice Address - Country:US
Practice Address - Phone:609-972-1070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNA8348163376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide