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General NPI Number Information
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NPI Number | 1750535340
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Entity Type | Individual
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Provider Name | THANIYA SULTANA BREMER RPA-C
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Gender | Female
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Dates
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Enumeration Date | 11/09/2008
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Last Update Date | 07/22/2019
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Provider Practice Location Address
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Address Line | 2510 30TH AVE
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City | ASTORIA
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State | NY
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Zip | 11102-2448
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Country | US
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Telephone | 718-932-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 3005 69TH ST FL 1
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City | WOODSIDE
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State | NY
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Zip | 11377-1231
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Country | US
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Telephone | 929-218-5359
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 012909
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License Number State | NY
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