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General NPI Number Information
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NPI Number | 1932914553
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Entity Type | Organization
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Legal Business Name | 7 SUSAN MEDICAL PC
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 770 GRAND BLVD STE 10
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City | DEER PARK
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State | NY
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Zip | 11729-5725
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Country | US
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Telephone | 347-264-6436
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Fax | 631-377-5727
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Provider Business Mailing Address
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Address Line | 770 GRAND BLVD STE 10
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City | DEER PARK
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State | NY
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Zip | 11729-5725
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Country | US
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Telephone | 347-264-6436
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Fax | 631-377-5727
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SAIQA IRAM
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Credential | MD
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Telephone | 347-264-6436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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