Provider Demographics
NPI:1952046088
Name:RAHMAN, NUR SHAFIQ (MD)
Entity Type:Individual
Prefix:
First Name:NUR
Middle Name:SHAFIQ
Last Name:RAHMAN
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 1:267 GRANT ST.
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06610
Mailing Address - Country:US
Mailing Address - Phone:203-384-3883
Mailing Address - Fax:203-384-4680
Practice Address - Street 1:267 GRANT STREET
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610
Practice Address - Country:US
Practice Address - Phone:203-384-3883
Practice Address - Fax:203-384-4680
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2023-03-01
Deactivation Date:2023-02-10
Deactivation Code:
Reactivation Date:2023-03-01
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program