Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 245018 | NY |
N | 2084N0402X | Child Neurologist | 245018 | NY |
NPI | 1194975151 |
---|---|
Provider Name | Dr. Sally Sultan |
First Address | New York, NY 10032-3726 |
Second Address | New York, NY 10032-3726 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2008 |
Last Update Date | 17/11/2021 |