Basic Information
| Provider Information | |||||||||
| NPI: | 1215283288 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAHMAN | ||||||||
| FirstName: | SELINA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1290 SILAS DEANE HWY | ||||||||
| Address2: | |||||||||
| City: | WETHERSFIELD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061094337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8609729033 | ||||||||
| FaxNumber: | 3218435177 | ||||||||
| Practice Location | |||||||||
| Address1: | 80 SEYMOUR ST BLDG 502 | ||||||||
| Address2: | |||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061028000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8609720549 | ||||||||
| FaxNumber: | 8605455221 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2012 | ||||||||
| LastUpdateDate: | 10/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 72556 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | ME128872 | FL | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | ME128872 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.