Provider Demographics
NPI:1407033020
Name:RAHMANOU, RAMIN (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:RAMIN
Middle Name:
Last Name:RAHMANOU
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 MIDDLE NECK RD
Mailing Address - Street 2:RITE AID PHARMACY
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-1246
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:152 MIDDLE NECK RD
Practice Address - Street 2:RITE AID PHARMACY
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-1246
Practice Address - Country:US
Practice Address - Phone:516-482-3833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040443-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist