Healthcare Provider Details

I. General information

NPI: 1881701803
Provider Name (Legal Business Name): MOHAMMED S REHMANI INTERNAL MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 01/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 COULTER RD
CLIFTON SPRINGS NY
14432-1122
US

IV. Provider business mailing address

2 COULTER RD
CLIFTON SPRINGS NY
14432-1122
US

V. Phone/Fax

Practice location:
  • Phone: 315-462-6500
  • Fax: 315-462-6731
Mailing address:
  • Phone: 315-462-6500
  • Fax: 315-462-6731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number193091
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number193091
License Number StateNY

VIII. Authorized Official

Name: DR. MOHAMMED SHEHBAL REHMANI
Title or Position: PRESIDENT
Credential: MD
Phone: 315-462-6500