MEDICARE: GUL RAHMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	054411	NY

General Provider Information

NPI Number	:	1205147907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUL RAHMAN

Provider Business Mailing Address
First Line	:	126 ECHOWOOD CT
Second Line	:
City	:	EAST AMHERST
State	:	NY
Zip	:	14051-2157
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2055 NIAGARA FALLS BLVD
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14228-3518
Country	:	US
Telephone Number	:	716-691-0738
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2010
Last Update Date	:	06/28/2010

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