Healthcare Provider Details

I. General information

NPI: 1326914987
Provider Name (Legal Business Name): SUHA M GHEITH WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

726 CORRELL AVE
STATEN ISLAND NY
10309-4255
US

IV. Provider business mailing address

726 CORRELL AVE
STATEN ISLAND NY
10309-4255
US

V. Phone/Fax

Practice location:
  • Phone: 917-723-9083
  • Fax:
Mailing address:
  • Phone: 917-723-9083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number421924
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: