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General NPI Number Information
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NPI Number | 1780657148
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Entity Type | Individual
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Provider Name | HASAN AIJAZ RIZVI MD
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Gender | Male
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 07/09/2019
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Provider Practice Location Address
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Address Line | 180 E MAIN ST SUITE #5
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City | BAY SHORE
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State | NY
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Zip | 11706-8427
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Country | US
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Telephone | 631-751-3000
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Fax | 631-675-2001
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Provider Business Mailing Address
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Address Line | 180 E MAIN ST STE 5
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City | BAY SHORE
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State | NY
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Zip | 11706-8427
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Country | US
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Telephone | 631-645-2842
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Fax | 866-252-3902
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology
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License Number | 158747
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License Number State | NY
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