Organization Active NPI

Rahman Maqsoodur Physician PC

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1114053311
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
168774 Issued in NY
Legal business name
RAHMAN MAQSOODUR PHYSICIAN PC
Practice address
602 Schenectady Ave
Brooklyn, NY 11203-1821
Phone
(718) 953-5700
Fax
(718) 953-5702
NPI assigned
Feb 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Maqsoodur Rahman, M.D.
Title
President
Phone
(718) 953-5700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 168774 NY Primary

Addresses

Primary practice location

602 Schenectady Ave
Brooklyn, NY 11203-1821

Mailing address

602 Schenectady Ave
Brooklyn, NY 11203-1821
Phone (718) 953-5700

Other identifiers 1

IdentifierTypeStateIssuer
00991786MedicaidNY

National Provider Directory

National Provider Directory

Locations

602 Schenectady Ave
Brooklyn, NY 11203
Phone (347) 522-3513

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114053311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 SCHENECTADY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031821",
            "telephone_number": "718-953-5700",
            "fax_number": "718-953-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 SCHENECTADY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031821",
            "telephone_number": "718-953-5700",
            "fax_number": "718-953-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAHMAN MAQSOODUR PHYSICIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAHMAN",
        "authorized_official_first_name": "MAQSOODUR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-953-5700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "168774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00991786",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.