Provider Demographics
NPI:1366998353
Name:RASID, IMRAN
Entity type:Individual
Prefix:
First Name:IMRAN
Middle Name:
Last Name:RASID
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 N STATE RT 17 STE 250
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2821
Mailing Address - Country:US
Mailing Address - Phone:201-835-0536
Mailing Address - Fax:201-335-0835
Practice Address - Street 1:140 N STATE RT 17 STE 250
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2821
Practice Address - Country:US
Practice Address - Phone:201-835-0536
Practice Address - Fax:201-335-0835
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)