1477840262 NPI number — M U REHMAN MD PC

Table of content: (NPI 1477840262)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477840262 NPI number — M U REHMAN MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
M U REHMAN MD PC
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:
Provider Other Organization Name Type Code:
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:
1477840262
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7057
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WATCHUNG
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07069-0799
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-899-1549
Provider Business Mailing Address Fax Number:
206-202-3153

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
190 GREENBROOK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH PLAINFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07060-3903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-899-1549
Provider Business Practice Location Address Fax Number:
206-202-3153
Provider Enumeration Date:
06/30/2011

Additional Information

Authorized Official

Authorized Official Last Name:
REHMAN
Authorized Official First Name:
MUHAMMAD
Authorized Official Middle Name:
U
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
908-899-1549

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  25MA08371300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM1300X , with the licence number: 25MA08371300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 11547019 . This is a "CAQH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 25MA08371300 . This is a "NJ LICENSE NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: D09259700 . This is a "CDS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0198315 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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