Healthcare Provider Details

I. General information

NPI: 1285945626
Provider Name (Legal Business Name): HUSAIN RIZVI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2010
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 FRONT ST STE 400
EAST MEADOW NY
11554-2265
US

IV. Provider business mailing address

1530 FRONT ST STE 400
EAST MEADOW NY
11554-2265
US

V. Phone/Fax

Practice location:
  • Phone: 516-324-7500
  • Fax:
Mailing address:
  • Phone: 516-324-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number273245
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: