MEDICARE: DR. NADIA RAHMAN O.D. & ASSOCIATES LLC

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	152W00000X	Optometrist	5991	OH

General Provider Information

NPI Number	:	1548620230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. NADIA RAHMAN O.D. & ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	33752 VINE ST
Second Line	:
City	:	WILLOWICK
State	:	OH
Zip	:	44095-5100
Country	:	US
Telephone Number	:	440-942-9315
Fax Number	:

Provider Business Practice Location Address
First Line	:	6592 SOM CT
Second Line	:
City	:	MAYFIELD VILLAGE
State	:	OH
Zip	:	44143-1599
Country	:	US
Telephone Number	:	440-942-9315
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NADIA RAHMAN
Credential	:	O.D.
Telephone Number	:	440-942-9315

Provider Enumeration Date	:	02/24/2016
Last Update Date	:	02/24/2016

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