Healthcare Provider Details

I. General information

NPI: 1275758948
Provider Name (Legal Business Name): MUNAZZA NAJEEB REHMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 12/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WALTER REED ARMY MEDICAL CENTER 6900 GEORGIA AVE NW ATTN MCHL-MAO-C
WASHINGTON DC
20307-0001
US

IV. Provider business mailing address

314 CHELSEA CT
HORSEHEADS NY
14845-2283
US

V. Phone/Fax

Practice location:
  • Phone: 202-782-7341
  • Fax:
Mailing address:
  • Phone: 607-796-2953
  • Fax: 413-793-7407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0062227
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberM6391
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number263366
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: