Healthcare Provider Details

I. General information

NPI: 1770374258
Provider Name (Legal Business Name): ALEEN RAHMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 DAVIS BLVD
JEFFERSON LA
70121-2205
US

IV. Provider business mailing address

19 DAVIS BLVD
NEW ORLEANS LA
70121-2205
US

V. Phone/Fax

Practice location:
  • Phone: 669-226-7386
  • Fax:
Mailing address:
  • Phone: 669-226-7386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number346648
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: