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General NPI Number Information
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NPI Number | 1780553800
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Entity Type | Individual
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Provider Name | MINARA RAHMAN OD
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Gender | Female
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Dates
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Enumeration Date | 11/05/2025
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 4600 E ROOSEVELT BLVD STE A-3
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City | PHILADELPHIA
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State | PA
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Zip | 19124-2358
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Country | US
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Telephone | 215-533-2595
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Fax |
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Provider Business Mailing Address
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Address Line | 101 WASHINGTON LN # W701
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City | JENKINTOWN
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State | PA
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Zip | 19046-3505
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Country | US
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Telephone | 646-856-6776
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG004324
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License Number State | PA
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