Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 25MA11131700 | NJ |
N | 204F00000X | Transplant Surgeon | 261664 | NY |
N | 208200000X | Surgeon | 261664 | NY |
N | 208600000X | Surgeon | 261664 | NY |
NPI | 1497997837 |
---|---|
Provider Name | Samuel Sultan |
First Address | Hackensack, NJ 07601-1997 |
Second Address | Hackensack, NJ 07601-1997 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2009 |
Last Update Date | 08/02/2022 |