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General NPI Number Information
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NPI Number | 1831920479
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Entity Type | Individual
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Provider Name | RIZWANUR KALEEL PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/13/2024
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 3546 STATE ROUTE 27
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City | KENDALL PARK
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State | NJ
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Zip | 08824-1065
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Country | US
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Telephone | 609-483-3411
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 95000, LB#7550
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City | PHILADELPHIA
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State | PA
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Zip | 19195-7550
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Country | US
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Telephone | 844-362-1735
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Fax | 973-290-7495
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00854300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MPO0854300
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License Number State | NJ
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