Provider Demographics
NPI:1588996482
Name:RAHMAN, NILPUAR (RPH)
Entity type:Individual
Prefix:
First Name:NILPUAR
Middle Name:
Last Name:RAHMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:294 MIDDLE COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-4428
Mailing Address - Country:US
Mailing Address - Phone:631-736-5168
Mailing Address - Fax:631-736-5733
Practice Address - Street 1:294 MIDDLE COUNTRY RD
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-4428
Practice Address - Country:US
Practice Address - Phone:631-736-5168
Practice Address - Fax:631-736-5733
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049111183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist