Provider Demographics
NPI:1215946983
Name:SAJJAD, REHANA (MD)
Entity type:Individual
Prefix:
First Name:REHANA
Middle Name:
Last Name:SAJJAD
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 1:725 MAPLE PLACE
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552
Mailing Address - Country:US
Mailing Address - Phone:516-564-0006
Mailing Address - Fax:516-564-4420
Practice Address - Street 1:62-54 97TH PLACE
Practice Address - Street 2:SUITE 2-E
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:718-271-9900
Practice Address - Fax:718-271-9911
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205577207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01840537Medicaid
NY01840537Medicaid
02681Medicare ID - Type Unspecified