Healthcare Provider Details

I. General information

NPI: 1821243809
Provider Name (Legal Business Name): MAAN S SALUJA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

756 LINCOLN AVE
BROOKLYN NY
11208-4102
US

IV. Provider business mailing address

756 LINCOLN AVE
BROOKLYN NY
11208-4102
US

V. Phone/Fax

Practice location:
  • Phone: 718-827-4321
  • Fax: 718-827-0415
Mailing address:
  • Phone: 718-827-4321
  • Fax: 718-827-0415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number109538
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: