Healthcare Provider Details

I. General information

NPI: 1598449290
Provider Name (Legal Business Name): ABDUL RAHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2023
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date: 01/17/2024
Reactivation Date: 02/21/2024

III. Provider practice location address

4500 PARSON BLVD SUITE 140
FLUSHING QUEENS NY
11355
US

IV. Provider business mailing address

4500 PARSON BLVD SUITE 140
FLUSHING QUEENS NY
11355
US

V. Phone/Fax

Practice location:
  • Phone: 718-670-5534
  • Fax:
Mailing address:
  • Phone: 718-670-5534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number..
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: