Healthcare Provider Details

I. General information

NPI: 1831009679
Provider Name (Legal Business Name): RAWDAH RAHIM OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6529 GRAND AVE
MASPETH NY
11378-2422
US

IV. Provider business mailing address

6529 GRAND AVE
MASPETH NY
11378-2422
US

V. Phone/Fax

Practice location:
  • Phone: 718-715-4871
  • Fax: 347-503-4090
Mailing address:
  • Phone: 718-715-4871
  • Fax: 347-503-4090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number029742
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: