Provider Demographics
NPI:1104032960
Name:RAHMAN, MOHAMMAD Z (RPH)
Entity Type:Individual
Prefix:MR
First Name:MOHAMMAD
Middle Name:Z
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-4437
Mailing Address - Country:US
Mailing Address - Phone:718-466-5555
Mailing Address - Fax:
Practice Address - Street 1:484 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-4437
Practice Address - Country:US
Practice Address - Phone:718-466-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02380385183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist