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General NPI Number Information
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NPI Number | 1750300950
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Entity Type | Individual
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Provider Name | RAHMAN ILKHANIZADEH MD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 849 57TH STREET STE 801
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City | BROOKLYN
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State | NY
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Zip | 11220-3797
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Country | US
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Telephone | 718-768-3560
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Fax | 212-500-3328
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Provider Business Mailing Address
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Address Line | 180 OLD WESTBURY RD
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City | OLD WESTBURY
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State | NY
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Zip | 11568-1100
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Country | US
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Telephone | 718-768-3560
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Fax | 212-500-3328
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 146711
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 146711
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License Number State | NY
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