1508186909 NPI number — FAWZI A SULIAMAN M.D.

Table of content: FAWZI A SULIAMAN M.D. (NPI 1508186909)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508186909 NPI number — FAWZI A SULIAMAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SULIAMAN
Provider First Name:
FAWZI
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508186909
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/16/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18 N 3RD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HIGHLAND PARK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08904-2408
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-545-0094
Provider Business Mailing Address Fax Number:
732-545-2750

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
926 N WOOD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINDEN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07036-4040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-925-3318
Provider Business Practice Location Address Fax Number:
908-925-8646
Provider Enumeration Date:
06/08/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207K00000X , with the licence number:  25MA08353900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P4196905 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 6325284 . This is a "AETNA HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 9508516 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1508186909 . This is a "U.S. FAMILY HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1750862 . This is a "GHI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 650932 . This is a "WELLCARE NJ" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0146653 . This is a "AMERIGROUP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 5528443 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 60105006 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 6N6791 . This is a "EMPIRE BC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 11303 . This is a "MAGNACARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2192317 . This is a "COVENTRY HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3249923 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0232963 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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