# S. R. ID GROUP PROFESSIONAL ASSOCIATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306184155
- **Authorized official:** DR. YASMEEN SULTANA M.D. (OWNER)
- **Authorized official phone:** (201) 563-5651

## Contact information

- **Practice address:** 703 MAIN ST, PATERSON, NJ 07503-2621
- **Practice address phone:** (973) 754-2770
- **Mailing address:** 11 GODWIN PL, CLIFTON, NJ 07013-3707
- **Mailing address phone:** (201) 563-5651

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | 25MA09126400 | NJ | Yes |

## Other

- **Enumeration date:** 01/29/2013
- **Last updated:** 01/29/2013