Provider Demographics
NPI:1902904709
Name:SULTANA, SHARMEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARMEEN
Middle Name:
Last Name:SULTANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 98TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-7605
Mailing Address - Country:US
Mailing Address - Phone:718-759-6015
Mailing Address - Fax:718-759-6016
Practice Address - Street 1:1414 NEWKIRK AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6599
Practice Address - Country:US
Practice Address - Phone:718-759-6015
Practice Address - Fax:718-759-6016
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226236207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPENDINGMedicaid
3740P1Medicare ID - Type Unspecified
I51979Medicare UPIN