Healthcare Provider Details
I. General information
NPI: 1144199878
Provider Name (Legal Business Name): MD ZUBAYDUR RAHMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/31/2025
Last Update Date: 10/31/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
162 KERNS AVE
BUFFALO NY
14211
US
IV. Provider business mailing address
162 KERNS AVE
BUFFALO NY
14211
US
V. Phone/Fax
- Phone: 646-744-5934
- Fax: 929-210-7550
- Phone: 646-744-5934
- Fax: 929-210-7550
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: