Provider Demographics
NPI:1447391552
Name:RAHMAN, NADIA (OD)
Entity Type:Individual
Prefix:DR
First Name:NADIA
Middle Name:
Last Name:RAHMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6592 SOM CT
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1599
Mailing Address - Country:US
Mailing Address - Phone:832-641-2491
Mailing Address - Fax:
Practice Address - Street 1:33752 VINE ST
Practice Address - Street 2:
Practice Address - City:EASTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44095-5114
Practice Address - Country:US
Practice Address - Phone:440-942-9315
Practice Address - Fax:440-942-9374
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046009910152W00000X
OH5994152W00000X
TX6858152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist