Provider Demographics
NPI:1629173240
Name:SALAMAT, RAHAT (MD)
Entity type:Individual
Prefix:DR
First Name:RAHAT
Middle Name:
Last Name:SALAMAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 GODWIN AVENUE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432
Mailing Address - Country:US
Mailing Address - Phone:201-689-7755
Mailing Address - Fax:201-689-0521
Practice Address - Street 1:44 GODWIN AVENUE
Practice Address - Street 2:SUITE 201
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432
Practice Address - Country:US
Practice Address - Phone:201-689-7755
Practice Address - Fax:201-689-0521
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004034876207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200599870 BMedicaid
MO207401100Medicaid
KS200599870 AMedicaid
I37441Medicare UPIN
MOP00000005Medicare PIN
MOP00712510Medicare PIN
MO207401100Medicaid
KS200599870 BMedicaid