Basic Information
| Provider Information | |||||||||
| NPI: | 1013630110 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SULTANA | ||||||||
| FirstName: | NOWSHIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6136 170TH ST APT M4 | ||||||||
| Address2: | |||||||||
| City: | FRESH MEADOWS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113651957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187090940 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1160 TELLER AVE | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104564145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182931500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2022 | ||||||||
| LastUpdateDate: | 09/22/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | P117927 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.