Healthcare Provider Details

I. General information

NPI: 1801967252
Provider Name (Legal Business Name): NAEEM UR REHMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 BRIGHTWATER CT #1F
BROOKLYN NY
11235-6641
US

IV. Provider business mailing address

711 BRIGHTWATER CT #1F
BROOKLYN NY
11235-6641
US

V. Phone/Fax

Practice location:
  • Phone: 718-934-4834
  • Fax:
Mailing address:
  • Phone: 718-934-4834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number242110
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: