Provider Demographics
NPI:1043844905
Name:SU SALUD MEDICAL PC
Entity type:Organization
Organization Name:SU SALUD MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:FERDOUS
Authorized Official - Middle Name:
Authorized Official - Last Name:KHANDKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-844-3360
Mailing Address - Street 1:1855 MOTT AVE
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4201
Mailing Address - Country:US
Mailing Address - Phone:718-868-8282
Mailing Address - Fax:718-471-2865
Practice Address - Street 1:1855 MOTT AVE
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4201
Practice Address - Country:US
Practice Address - Phone:718-200-0723
Practice Address - Fax:718-471-2865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-28
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty