Provider Demographics
NPI:1851733323
Name:RANGREZ, JAVEED AHMED (BO, CPO)
Entity Type:Individual
Prefix:MR
First Name:JAVEED
Middle Name:AHMED
Last Name:RANGREZ
Suffix:
Gender:M
Credentials:BO, CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4223 FRANCIS LEWIS BLVD # M201
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2575
Mailing Address - Country:US
Mailing Address - Phone:718-952-4341
Mailing Address - Fax:833-652-1544
Practice Address - Street 1:4223 FRANCIS LEWIS BLVD # M201
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2575
Practice Address - Country:US
Practice Address - Phone:718-952-4341
Practice Address - Fax:833-652-1544
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC49842224P00000X, 222Z00000X, 224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist