Healthcare Provider Details

I. General information

NPI: 1932855152
Provider Name (Legal Business Name): NAYAB RIZVI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NAYAB HUSSAIN

II. Dates (important events)

Enumeration Date: 02/25/2022
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 W CENTRAL ST
NATICK MA
01760-4514
US

IV. Provider business mailing address

14 W CENTRAL ST
NATICK MA
01760-4514
US

V. Phone/Fax

Practice location:
  • Phone: 508-720-5000
  • Fax: 508-720-2090
Mailing address:
  • Phone: 508-720-5000
  • Fax: 508-720-2090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1859392
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: