Provider Demographics
NPI:1427525526
Name:RAHMAN, ANEESAH M (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:ANEESAH
Middle Name:M
Last Name:RAHMAN
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 20TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-1180
Mailing Address - Country:US
Mailing Address - Phone:718-431-8725
Mailing Address - Fax:718-431-8709
Practice Address - Street 1:164 20TH ST STE 4C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-1151
Practice Address - Country:US
Practice Address - Phone:718-431-8725
Practice Address - Fax:718-431-8709
Is Sole Proprietor?:No
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY746290-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse