Provider Demographics
NPI:1326051749
Name:RAHMAN, QUAZI T (MD)
Entity Type:Individual
Prefix:
First Name:QUAZI
Middle Name:T
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 E 19TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-1807
Mailing Address - Country:US
Mailing Address - Phone:347-627-6555
Mailing Address - Fax:718-245-2526
Practice Address - Street 1:751 E 19TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-1807
Practice Address - Country:US
Practice Address - Phone:347-627-6555
Practice Address - Fax:347-627-6555
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236860-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02671025Medicaid
NYI40582Medicare UPIN
NY02671025Medicaid