Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0401X | Internist - Addiction Medicine | 161420 | NY |
N | 208D00000X | General Practice Physician | 161420 | NY |
NPI | 1437378502 |
---|---|
Provider Name | Dr. Ronald Rahman |
First Address | Bronx, NY 10461-4509 |
Second Address | Bronx, NY 10461-4509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 08/07/2007 |