Provider Demographics
NPI:1003685686
Name:RAHAT, SYED
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:
Last Name:RAHAT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-6256
Mailing Address - Country:US
Mailing Address - Phone:773-492-8648
Mailing Address - Fax:
Practice Address - Street 1:645 3RD ST
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-6256
Practice Address - Country:US
Practice Address - Phone:773-492-8648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker