Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD042473E | PA |
N | 111NI0900X | Internist | MD042473E | PA |
N | 207RG0300X | Geriatric Medicine | MD042473E | PA |
NPI | 1124102124 |
---|---|
Provider Name | Nader Rahmanian |
First Address | Wyomissing, PA 19610 |
Second Address | Wyomissing, PA 19610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012080040002 | (05) | PA |
E55693 | (02) |