Basic Information
| Provider Information | |||||||||
| NPI: | 1487944005 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAHMAN | ||||||||
| FirstName: | AQSA | ||||||||
| MiddleName: | FAHD | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2821 ISLAND AVE STE 131 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191532327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2158636171 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1500 LANSDOWNE AVE | ||||||||
| Address2: | |||||||||
| City: | DARBY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190231200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102374000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2011 | ||||||||
| LastUpdateDate: | 10/06/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 25MA09773400 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 25MA09773400 | NJ | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | MT197515 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.