Healthcare Provider Details

I. General information

NPI: 1932914553
Provider Name (Legal Business Name): 7 SUSAN MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 GRAND BLVD STE 10
DEER PARK NY
11729-5725
US

IV. Provider business mailing address

770 GRAND BLVD STE 10
DEER PARK NY
11729-5725
US

V. Phone/Fax

Practice location:
  • Phone: 347-264-6436
  • Fax: 631-377-5727
Mailing address:
  • Phone: 347-264-6436
  • Fax: 631-377-5727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SAIQA IRAM
Title or Position: PHYSICIAN
Credential: MD
Phone: 347-264-6436