1447277918 NPI number — DR. TARIQ AHMAD RIZVI MD

Table of content: DR. TARIQ AHMAD RIZVI MD (NPI 1447277918)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447277918 NPI number — DR. TARIQ AHMAD RIZVI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIZVI
Provider First Name:
TARIQ
Provider Middle Name:
AHMAD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447277918
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
75 VERONICA AVE
Provider Second Line Business Mailing Address:
SUITE 204
Provider Business Mailing Address City Name:
SOMERSET
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08873-5002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-828-0002
Provider Business Mailing Address Fax Number:
732-828-7070

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 VERONICA AVE
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
SOMERSET
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08873-5002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-828-0002
Provider Business Practice Location Address Fax Number:
732-828-7070
Provider Enumeration Date:
07/17/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)