Healthcare Provider Details

I. General information

NPI: 1366670598
Provider Name (Legal Business Name): SULEIMAN HALAIBEH MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 07/22/2022
Certification Date: 07/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 FRANKLIN ST UNIT 7
WESTERLY RI
02891-3149
US

IV. Provider business mailing address

SA. INC. MEDICAL SERVICES, AVE. LAURO PINERO 195 CEIB
CEIBA PUERTO RICO
00735
UM

V. Phone/Fax

Practice location:
  • Phone: 401-315-0220
  • Fax:
Mailing address:
  • Phone: 787-885-4141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number18410
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: