=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265809636
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROBERT RAHMANI HEART & VASCULAR PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2015
-----------------------------------------------------
Last Update Date | 09/01/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 287 NORTHERN BLVD SUITE 108
-----------------------------------------------------
City | GREAT NECK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11021-4700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-627-5430
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7 SOUTH ST
-----------------------------------------------------
City | GREAT NECK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11023-1218
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-627-5430
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MD
-----------------------------------------------------
Name | ROBERT RAHMANI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 516-627-5430
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 253417
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------