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General NPI Number Information
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NPI Number | 1477618866
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Entity Type | Individual
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Provider Name | RABIA SULTANA AWAN M.D
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Gender | Female
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 10/09/2018
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Provider Practice Location Address
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Address Line | 201 LYONS AVE STE D-3
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City | NEWARK
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State | NJ
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Zip | 07112
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Country | US
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Telephone | 973-926-8828
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Fax | 973-923-2061
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Provider Business Mailing Address
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Address Line | 101 ROXY AVE
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City | EDISON
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State | NJ
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Zip | 08820-1939
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Country | US
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Telephone | 908-420-4429
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MA60390
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License Number State | NJ
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