Individual
MR. GHULAM RABBANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
317 BROADWAY STE B, AMITYVILLE, NY 11701-2770
(631) 598-4897
Mailing address
317 BROADWAY STE B, AMITYVILLE, NY 11701-2770
(631) 598-4897
(631) 464-4107
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
P100032
NY
363AM0700X
Medical Physician Assistant
Primary
P100032
NY
Other
Enumeration date
04/25/2019
Last updated
02/25/2020
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