Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 25MA11172500 | NJ |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 298858-1 | NY |
NPI | 1023438199 |
---|---|
Provider Name | Suhyla Alam |
First Address | Boston, MA 02241-3446 |
Second Address | New Providence, NJ 07974-1505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2014 |
Last Update Date | 10/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05814562 | (05) | NY |