Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 111932 | NY |
NPI | 1629291612 |
---|---|
Provider Name | Dr. Leon Sultan |
First Address | Elberon, NJ 07740-8029 |
Second Address | Franklin Square, NY 07740-1436 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 08/07/2007 |