Provider Demographics
NPI:1003950593
Name:RAHMANI, KAMRAN (MD)
Entity type:Individual
Prefix:DR
First Name:KAMRAN
Middle Name:
Last Name:RAHMANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W 103RD ST APT 12A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-4479
Mailing Address - Country:US
Mailing Address - Phone:212-666-1864
Mailing Address - Fax:212-665-5194
Practice Address - Street 1:250 W 103RD ST APT 12A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-4479
Practice Address - Country:US
Practice Address - Phone:212-666-1864
Practice Address - Fax:212-665-5194
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1767322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01712665Medicaid
NY01712665Medicaid
NYE17712Medicare UPIN