MEDICARE: MOHAMMAD RAHMAN, PHYSICIAN, PC

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	261QR0400X	Rehabilitation Clinic/Center	213014	NY

General Provider Information

NPI Number	:	1962607085
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOHAMMAD RAHMAN, PHYSICIAN, PC

Provider Business Mailing Address
First Line	:	8635 QUEENS BLVD
Second Line	:	SUITE 1A
City	:	ELMHURST
State	:	NY
Zip	:	11373-4434
Country	:	US
Telephone Number	:	718-533-8588
Fax Number	:	718-533-1249

Provider Business Practice Location Address
First Line	:	8635 QUEENS BLVD
Second Line	:	SUITE 1A
City	:	ELMHURST
State	:	NY
Zip	:	11373-4434
Country	:	US
Telephone Number	:	718-533-8588
Fax Number	:	718-533-1249

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MOHAMMAD ANISUR RAHMAN
Credential	:	MD
Telephone Number	:	718-533-8588

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	08/22/2020

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