Active NPI
Suda Jirasakuldej
- Neurology with Special Qualifications in Child Neurology Physician
- New York, NY
National Provider Identifier
1356504302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology with Special Qualifications in Child Neurology Physician
- License
- 271391-1
- Practice address
- 710 W 168TH St
7TH Floor
New York, NY 10032-3726 - Phone
- (212) 305-1742
- NPI assigned
- Jul 9, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | 271391-1 | NY | Primary |
Addresses
Primary practice location
710 W 168TH St
7TH Floor
New York, NY 10032-3726
Mailing address
710 W 168TH St
7TH Floor
New York, NY 10032-3726
Phone (212) 305-1742
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 271391-1 | NY | MD | Neurology with Special Qualifications in Child Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405468800000",
"number": "1356504302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 W 168TH ST",
"address_2": "7TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323726",
"telephone_number": "212-305-1742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 W 168TH ST",
"address_2": "7TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323726",
"telephone_number": "212-305-1742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIRASAKULDEJ",
"first_name": "SUDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-09",
"last_updated": "2014-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "NY",
"license": "271391-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.