Healthcare Provider Details

I. General information

NPI: 1801842000
Provider Name (Legal Business Name): ZAFER N. SOULTAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 09/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E ADAMS ST
SYRACUSE NY
13210-2306
US

IV. Provider business mailing address

750 E ADAMS ST
SYRACUSE NY
13210-2306
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-5450
  • Fax: 315-464-6322
Mailing address:
  • Phone: 315-464-5450
  • Fax: 315-464-6322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number230424
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License Number230424
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: