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General NPI Number Information
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NPI Number | 1952037038
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Entity Type | Individual
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Provider Name | SIDDIQUR RAHMAN LMHC
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Gender | Male
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Dates
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Enumeration Date | 07/29/2022
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 2258 78TH ST FL 3
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City | EAST ELMHURST
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State | NY
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Zip | 11370-2102
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Country | US
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Telephone | 646-270-5906
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Fax |
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Provider Business Mailing Address
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Address Line | 2258 78TH ST FL 3
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City | EAST ELMHURST
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State | NY
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Zip | 11370-2102
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Country | US
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Telephone | 646-270-5906
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0-12664
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License Number State | NY
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