Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 4301103766 | MI |
N | 207U00000X | Nuclear Medicine Specialist | D0080742 | MD |
NPI | 1306287396 |
---|---|
Provider Name | Dr. Ayub Suleiman |
First Address | Staten Island, NY 10310-1664 |
Second Address | Staten Island, NY 10310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2013 |
Last Update Date | 08/07/2018 |