Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 46TR00812100 | NJ |
NPI | 1033783865 |
---|---|
Provider Name | Amal Suliaman |
First Address | Cliffside Park, NJ 07010-1812 |
Second Address | Cliffside Park, NJ 07010-1812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2021 |
Last Update Date | 17/05/2021 |