Provider Demographics
NPI:1548230386
Name:KASSAM, RAHIMA (DC)
Entity Type:Individual
Prefix:DR
First Name:RAHIMA
Middle Name:
Last Name:KASSAM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WILLARD ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-1200
Mailing Address - Country:US
Mailing Address - Phone:617-471-4491
Mailing Address - Fax:617-471-1114
Practice Address - Street 1:111 WILLARD ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-1200
Practice Address - Country:US
Practice Address - Phone:617-471-4491
Practice Address - Fax:617-471-1114
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9893111NN0400X
MA03286111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX11445441OtherCAQH
TX12300656OtherMULTIPLAN
TX7866652OtherAETNA
TX13425OtherUHS
TX1057093OtherASH
TX8R1170OtherBCBS
TX4755661OtherCIGNA
TX8R1170OtherBCBS
TX13425OtherUHS
TX4755661OtherCIGNA