Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 163626 | NY |
N | 208000000X | Pediatrician | 163626 | NY |
NPI | 1093812505 |
---|---|
Provider Name | Dr. Tanveer A Sultan |
First Address | Troy, NY 12180 |
Second Address | Troy, NY 12180 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2006 |
Last Update Date | 13/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000408210001 | BCBS (01) | NY |
01450095 | (05) | NY |
69645F | (02) | NY |