Healthcare Provider Details

I. General information

NPI: 1548230386
Provider Name (Legal Business Name): RAHIMA KASSAM D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 07/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 WILLARD ST SUITE 2A
QUINCY MA
02169-1200
US

IV. Provider business mailing address

111 WILLARD ST SUITE 2A
QUINCY MA
02169-1200
US

V. Phone/Fax

Practice location:
  • Phone: 617-471-4491
  • Fax: 617-471-1114
Mailing address:
  • Phone: 617-471-4491
  • Fax: 617-471-1114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number9893
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number03286
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: