Provider Demographics
NPI:1184102626
Name:RUHULLAH, SANAH F
Entity type:Individual
Prefix:
First Name:SANAH
Middle Name:F
Last Name:RUHULLAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SANAH
Other - Middle Name:F
Other - Last Name:RUHULLAH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:18-5 CALLE 5
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3312
Mailing Address - Country:US
Mailing Address - Phone:551-358-3130
Mailing Address - Fax:
Practice Address - Street 1:PUERTO RICO CHILDREN'S HOSPITAL
Practice Address - Street 2:CARR 2 KM 11.9 INTERIOR BO LOS PAJAROS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957
Practice Address - Country:US
Practice Address - Phone:787-474-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR34006R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics