Basic Information
| Provider Information | |||||||||
| NPI: | 1225169956 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JAVED SULEMAN M.D. P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14305 HILLSIDE AVE | ||||||||
| Address2: | |||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114353230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182970440 | ||||||||
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| Practice Location | |||||||||
| Address1: | 14305 HILLSIDE AVE | ||||||||
| Address2: | |||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114353230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182970440 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2007 | ||||||||
| LastUpdateDate: | 07/24/2007 | ||||||||
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| AuthorizedOfficialLastName: | SULEMAN | ||||||||
| AuthorizedOfficialFirstName: | JAVED | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3472490768 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
No ID Information.