Provider Demographics
NPI:1689435356
Name:RAHMAN, MD MAMUNUR
Entity Type:Individual
Prefix:
First Name:MD
Middle Name:MAMUNUR
Last Name:RAHMAN
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 1:8810 178TH ST APT 4P
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4619
Mailing Address - Country:US
Mailing Address - Phone:929-393-0343
Mailing Address - Fax:
Practice Address - Street 1:8810 178TH ST APT 4P
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4619
Practice Address - Country:US
Practice Address - Phone:929-393-0343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant