MEDICARE: DR. RIZWAN RABBANI MBBS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1558037341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RIZWAN RABBANI MBBS

Provider Business Mailing Address
First Line	:	3440 N BROAD ST STE 100
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-5104
Country	:	US
Telephone Number	:	215-707-0744
Fax Number	:	215-707-9697

Provider Business Practice Location Address
First Line	:	3440 N BROAD ST STE 100
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-5104
Country	:	US
Telephone Number	:	215-707-0744
Fax Number	:	215-707-9697

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2021
Last Update Date	:	08/20/2021

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