Healthcare Provider Details

I. General information

NPI: 1659304509
Provider Name (Legal Business Name): ROXANA SULICA M.D.,
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16TH STREET AT 1ST AVENUE
NEW YORK NY
10003
US

IV. Provider business mailing address

PO BOX 95000-2433
PHILADELPHIA PA
19195-2433
US

V. Phone/Fax

Practice location:
  • Phone: 212-420-2377
  • Fax:
Mailing address:
  • Phone: 212-844-8824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number241675
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number001968
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: