1235145442 NPI number — RASOOL & SHAH HOSSEINI INC

Table of content: (NPI 1235145442)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235145442 NPI number — RASOOL & SHAH HOSSEINI INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RASOOL & SHAH HOSSEINI INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BROOKLINE DENTAL CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235145442
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1199 BEACON ST
Provider Second Line Business Mailing Address:
UNIT 1
Provider Business Mailing Address City Name:
BROOKLINE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02446-5352
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-734-8599
Provider Business Mailing Address Fax Number:
617-739-8452

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1199 BEACON ST
Provider Second Line Business Practice Location Address:
UNIT 1
Provider Business Practice Location Address City Name:
BROOKLINE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02446-5352
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-734-8599
Provider Business Practice Location Address Fax Number:
617-739-8452
Provider Enumeration Date:
07/31/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RASOOL
Authorized Official First Name:
S
Authorized Official Middle Name:
FAHEEM
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
617-734-8599

Provider Taxonomy Codes

  • Taxonomy code: 1223P0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223P0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223P0700X , with the licence number: 18801 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)