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General NPI Number Information
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NPI Number | 1417766890
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Entity Type | Individual
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Provider Name | MOHAMMAD EKHTIAR RAHMAN CRNP
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Gender | Male
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Dates
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Enumeration Date | 12/31/2024
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 176 VIRGINIA AVE
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City | ROCHESTER
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State | PA
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Zip | 15074-1723
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Country | US
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Telephone | 724-300-2971
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Fax | 724-300-2923
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Provider Business Mailing Address
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Address Line | 100 SHENANGO AVE
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City | SHARON
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State | PA
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Zip | 16146-1503
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Country | US
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Telephone | 724-300-2971
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Fax | 724-300-2923
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP031725
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License Number State | PA
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