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NPI Code Detail

MEDICARE: SYED M RIZVI MD LLC

MEDICARE: SYED M RIZVI MD LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianMD421641PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11642940OTHERHIGHMARK BLUE SHIELD
22862828000OTHERAMERIHEALTH PPO
37401590OTHERAETNA
41948986OTHERPREMIER BLUE

General Provider Information

NPI Number : 1013048354
Entity Type Code : Organization
Provider Name (Legal Business Name) : SYED M RIZVI MD LLC
Provider Business Mailing Address
First Line : PO BOX 162
Second Line :
City : WYNNEWOOD
State : PA
Zip : 19096-0162
Country : US
Telephone Number : 610-291-2269
Fax Number :
Provider Business Practice Location Address
First Line : 340 N MIDDLETOWN RD
Second Line :
City : MEDIA
State : PA
Zip : 19063-5505
Country : US
Telephone Number : 610-891-5840
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : SYED M RIZVI
Credential : M.D.
Telephone Number : 610-291-2269
Provider Enumeration Date : 03/08/2007
Last Update Date : 09/25/2009

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Directions to “SYED M RIZVI MD LLC ” Practice Location

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