Basic Information
| Provider Information | |||||||||
| NPI: | 1023196425 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAHMAN | ||||||||
| FirstName: | MUHAMMED | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | B.S,B.S(PHARMACY) | ||||||||
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| Mailing Information | |||||||||
| Address1: | 221 STONE ST | ||||||||
| Address2: | |||||||||
| City: | ELMONT | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110032240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167756853 | ||||||||
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| Practice Location | |||||||||
| Address1: | 506 MALCOLM X BLVD | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100371802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129391761 | ||||||||
| FaxNumber: | 2129391759 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835X0200X | 030989 | NY | Y | Pharmacy Service Providers | Pharmacist | Oncology |
No ID Information.