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General NPI Number Information
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NPI Number | 1063050144
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Entity Type | Individual
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Provider Name | RIZWAN ATIQ RPH
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Gender | Male
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Dates
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Enumeration Date | 12/19/2019
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 301 E MAIN ST
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City | BAY SHORE
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State | NY
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Zip | 11706-8458
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Country | US
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Telephone | 917-547-2916
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Fax |
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Provider Business Mailing Address
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Address Line | 8521 168TH ST FL 2
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City | JAMAICA
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State | NY
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Zip | 11432-2623
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Country | US
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Telephone | 917-547-2916
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 066135
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License Number State | NY
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