Provider Demographics
NPI:1346291655
Name:DHANANI, RAHIM (MD)
Entity Type:Individual
Prefix:
First Name:RAHIM
Middle Name:
Last Name:DHANANI
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 1:62 HACKETT BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12209-1756
Mailing Address - Country:US
Mailing Address - Phone:518-434-2244
Mailing Address - Fax:518-434-4659
Practice Address - Street 1:62 HACKETT BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12209-1756
Practice Address - Country:US
Practice Address - Phone:518-434-2244
Practice Address - Fax:518-434-4659
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002938-1207R00000X, 208000000X
NY251486207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02932603Medicaid
NYP00446591OtherRR MEDICARE