Healthcare Provider Details

I. General information

NPI: 1346291655
Provider Name (Legal Business Name): RAHIM DHANANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 04/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 HACKETT BLVD
ALBANY NY
12209-1756
US

IV. Provider business mailing address

62 HACKETT BLVD
ALBANY NY
12209-1756
US

V. Phone/Fax

Practice location:
  • Phone: 518-434-2244
  • Fax: 518-434-4659
Mailing address:
  • Phone: 518-434-2244
  • Fax: 518-434-4659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number002938-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number002938-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number251486
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: