Provider Demographics
NPI:1568498590
Name:PERVEZ, RAHILA (MD)
Entity Type:Individual
Prefix:
First Name:RAHILA
Middle Name:
Last Name:PERVEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 NEWKIRK PLZ
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-6525
Mailing Address - Country:US
Mailing Address - Phone:718-434-7545
Mailing Address - Fax:718-434-7564
Practice Address - Street 1:29 NEWKIRK PLZ
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6525
Practice Address - Country:US
Practice Address - Phone:718-434-7545
Practice Address - Fax:718-434-7564
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY195819207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01537159Medicaid