Provider Demographics
NPI:1538186325
Name:SULEMAN, RANA JAVED (MD)
Entity type:Individual
Prefix:MRS
First Name:RANA
Middle Name:JAVED
Last Name:SULEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:RANA
Other - Middle Name:JAVED
Other - Last Name:SULEMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9173 111TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-3006
Mailing Address - Country:US
Mailing Address - Phone:718-441-1373
Mailing Address - Fax:718-441-1017
Practice Address - Street 1:9173 111TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-3006
Practice Address - Country:US
Practice Address - Phone:718-441-1373
Practice Address - Fax:718-441-1017
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY221513207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02296739Medicaid
NY02296739Medicaid
NYG300092636Medicare PIN