Provider Demographics
NPI:1619363553
Name:RANA, MD RASEL
Entity Type:Individual
Prefix:
First Name:MD
Middle Name:RASEL
Last Name:RANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9220 168TH PL FL 2
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11433-1239
Mailing Address - Country:US
Mailing Address - Phone:347-605-2821
Mailing Address - Fax:347-923-3217
Practice Address - Street 1:8742 169TH ST FL 1
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3632
Practice Address - Country:US
Practice Address - Phone:347-605-2821
Practice Address - Fax:347-923-3217
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011370225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant