Provider Demographics
NPI:1881877082
Name:KHAWAJA M. RAHMAN, M.D., PROFESSIONAL ASSOCIATION
Entity type:Organization
Organization Name:KHAWAJA M. RAHMAN, M.D., PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KHAWAJA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-881-7100
Mailing Address - Street 1:171 KINSLEY ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3654
Mailing Address - Country:US
Mailing Address - Phone:603-881-7100
Mailing Address - Fax:603-598-9049
Practice Address - Street 1:171 KINSLEY ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3654
Practice Address - Country:US
Practice Address - Phone:603-881-7100
Practice Address - Fax:603-598-9049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH76552084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH10905443OtherCAQH
NH30002941Medicaid
NH10905443OtherCAQH
NH30002941Medicaid