Healthcare Provider Details

I. General information

NPI: 1720991979
Provider Name (Legal Business Name): MARIA SULEJMENI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 ROUTE 3
CLIFTON NJ
07014-1900
US

IV. Provider business mailing address

407 HIGHLAND AVE
ORANGE NJ
07050-2419
US

V. Phone/Fax

Practice location:
  • Phone: 973-933-1111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00961600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: