Mohamed Fazal Rahaman, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35SI00477300 Issued in NJ

Practice address

860 US Highway 1
Suite 4
Edison, NJ 08817-4687

Phone

(732) 737-7395

Fax

(848) 260-0818

NPI assigned

Nov 5, 2010

Last updated

Nov 5, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288915200000",
    "number": "1679874762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 US HIGHWAY 1",
            "address_2": "SUITE 4",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088174687",
            "telephone_number": "732-737-7395",
            "fax_number": "848-260-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 US HIGHWAY 1",
            "address_2": "SUITE 4",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088174687",
            "telephone_number": "732-737-7395",
            "fax_number": "848-260-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHAMAN",
        "first_name": "MOHAMED",
        "middle_name": "FAZAL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-05",
        "last_updated": "2010-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00477300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Radical Physical Therapy LLC
• Farouz Rafih, MD
• Marina Ragheb, DO
• Rukiya Raghunath
• Ragin Patel MD LLC
• Rahil Patel M.D. LLC
• Gagandeep Singh Rai, M.D.
• Rainbow Kids Dental, Inc.
• Fatema Raja, PA
• Mohammad Hanif Raja

• Clinical Psychologist in Edison, NJ
• Providers in Edison, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.