Provider Demographics
NPI:1154566198
Name:SEYAM, REHAN HASSANIN
Entity type:Individual
Prefix:MRS
First Name:REHAN
Middle Name:HASSANIN
Last Name:SEYAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 DERROM AVENUE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07504
Mailing Address - Country:US
Mailing Address - Phone:973-278-7070
Mailing Address - Fax:
Practice Address - Street 1:152 DERROM AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07504-1003
Practice Address - Country:US
Practice Address - Phone:973-278-7070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-04
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00414800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health