Individual provider Active NPI

Dilara Rakhman, M.D.

  • Pediatric Adolescent Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1992760052
Registry record updated Feb 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
228753 Issued in NY
Practice address
2704 Glenwood Rd
Mark B. Lew, MD, LLC
Brooklyn, NY 11210-2326
Phone
(718) 859-6440
Fax
(718) 434-0368
NPI assigned
Apr 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 228753 NY Primary

Addresses

Primary practice location

2704 Glenwood Rd
Mark B. Lew, MD, LLC
Brooklyn, NY 11210-2326

Mailing address

2704 Glenwood Rd
Mark B. Lew, MD, LLC
Brooklyn, NY 11210-2326
Phone (718) 859-6440

Other identifiers 1

IdentifierTypeStateIssuer
02471887MedicaidNY

Other names 1

  • Dilara Rakhmanova Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
228753NYMDPediatric Adolescent Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1992760052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 GLENWOOD RD",
            "address_2": "MARK B. LEW, MD, LLC",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112102326",
            "telephone_number": "718-859-6440",
            "fax_number": "718-434-0368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 GLENWOOD RD",
            "address_2": "MARK B. LEW, MD, LLC",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112102326",
            "telephone_number": "718-859-6440",
            "fax_number": "718-434-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKHMAN",
        "first_name": "DILARA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "228753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02471887",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DILARA",
            "last_name": "RAKHMANOVA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Feb 28, 2012; 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.