Provider Demographics
NPI:1538154901
Name:RAHMAN, MOHAMMED ZIAUR (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:ZIAUR
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-1622
Mailing Address - Country:US
Mailing Address - Phone:516-483-1100
Mailing Address - Fax:516-483-2200
Practice Address - Street 1:151 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-1622
Practice Address - Country:US
Practice Address - Phone:516-483-1100
Practice Address - Fax:516-483-2200
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179175-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01694760Medicaid
NY01694760Medicaid
NYF92316Medicare UPIN