Provider Demographics
NPI:1043980196
Name:RAHIM, SANA
Entity type:Individual
Prefix:
First Name:SANA
Middle Name:
Last Name:RAHIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SANA
Other - Middle Name:LATIF
Other - Last Name:MEMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:4 MEADOWBROOK RD
Mailing Address - Street 2:
Mailing Address - City:WATERVLIET
Mailing Address - State:NY
Mailing Address - Zip Code:12189-1125
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3437 CARMAN RD
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-5424
Practice Address - Country:US
Practice Address - Phone:518-357-2770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025067225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics