MEDICARE: ROSEY SULTANA MEDICAL CARE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1588403810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSEY SULTANA MEDICAL CARE PC

Provider Business Mailing Address
First Line	:	3 WOOD ACRES RD
Second Line	:
City	:	GLEN HEAD
State	:	NY
Zip	:	11545-2911
Country	:	US
Telephone Number	:	718-313-4545
Fax Number	:	718-313-4546

Provider Business Practice Location Address
First Line	:	10302 LEFFERTS BLVD
Second Line	:
City	:	SOUTH RICHMOND HILL
State	:	NY
Zip	:	11419-2012
Country	:	US
Telephone Number	:	718-313-4545
Fax Number	:	718-313-4546

Authorized Official
Title or Position	:	OWNER
Name	:	ROSEY SULTANA
Credential	:	MD
Telephone Number	:	718-313-4545

Provider Enumeration Date	:	05/24/2024
Last Update Date	:	05/24/2024

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