Provider Demographics
NPI:1659309433
Name:RAHMAN, SAYEDUR (MD)
Entity type:Individual
Prefix:DR
First Name:SAYEDUR
Middle Name:
Last Name:RAHMAN
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 1:665 TERRYVILLE AVE
Mailing Address - Street 2:P. O. BOX 156
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-4078
Mailing Address - Country:US
Mailing Address - Phone:860-589-5911
Mailing Address - Fax:
Practice Address - Street 1:665 TERRYVILLE AVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4078
Practice Address - Country:US
Practice Address - Phone:860-589-5911
Practice Address - Fax:860-585-8257
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT020079207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001200799Medicaid
CT001200799Medicaid