Provider Demographics
NPI:1174901235
Name:EZEKIEL, SULMEET AARON (APN)
Entity type:Individual
Prefix:
First Name:SULMEET
Middle Name:AARON
Last Name:EZEKIEL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:SULMEET
Other - Middle Name:AARON
Other - Last Name:HYAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:36 CHATSWORTH RD
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-4185
Mailing Address - Country:US
Mailing Address - Phone:732-851-4875
Mailing Address - Fax:
Practice Address - Street 1:36 CHATSWORTH RD
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-4185
Practice Address - Country:US
Practice Address - Phone:732-851-4875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-11
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00550300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily