Healthcare Provider Details

I. General information

NPI: 1033817440
Provider Name (Legal Business Name): ANIKA RAHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 02/16/2023
Certification Date: 02/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 E 180TH ST
BRONX NY
10460-1305
US

IV. Provider business mailing address

8317 168TH PL
JAMAICA NY
11432-1912
US

V. Phone/Fax

Practice location:
  • Phone: 718-618-7436
  • Fax:
Mailing address:
  • Phone: 347-605-4602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number070129
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: