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General NPI Number Information
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NPI Number | 1093687402
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Entity Type | Individual
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Provider Name | FAHIM RAHMAT ULLAH
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Gender | Male
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 28652 STATE HIGHWAY 23
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City | STAMFORD
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State | NY
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Zip | 12167-1712
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Country | US
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Telephone | 516-862-1202
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Fax |
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Provider Business Mailing Address
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Address Line | 610 WINTERS LN
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City | CATONSVILLE
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State | MD
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Zip | 21228-2833
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Country | US
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Telephone | 443-600-3102
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 60-P138174-01
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License Number State | NY
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