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General NPI Number Information
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NPI Number | 1285778258
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Entity Type | Individual
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Provider Name | JAMIL F RIZQALLA DO
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Gender | Male
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 651 WEST MOUNT PLEASANT AVE
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City | LIVINGSTON
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State | NJ
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Zip | 07039
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Country | US
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Telephone | 973-740-0607
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Fax | 973-740-9895
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Provider Business Mailing Address
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Address Line | 651 W MOUNT PLEASANT AVE
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City | LIVINGSTON
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State | NJ
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Zip | 07039-1600
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Country | US
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Telephone | 973-740-0607
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Fax | 973-740-9895
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 5101015686
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 245032
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License Number State | NY
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