Provider Demographics
NPI:1629942362
Name:RAHAMAN, REYNA
Entity type:Individual
Prefix:
First Name:REYNA
Middle Name:
Last Name:RAHAMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 OAKRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-4540
Mailing Address - Country:US
Mailing Address - Phone:973-518-2196
Mailing Address - Fax:
Practice Address - Street 1:491 BLOOMFIELD AVE STE 103
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-3406
Practice Address - Country:US
Practice Address - Phone:732-647-9857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-04
Last Update Date:2025-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00914800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health