Provider Demographics
NPI:1144202433
Name:RIZK, DAHLIA (DO)
Entity Type:Individual
Prefix:
First Name:DAHLIA
Middle Name:
Last Name:RIZK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 95000-2433
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-2433
Mailing Address - Country:US
Mailing Address - Phone:212-844-1808
Mailing Address - Fax:
Practice Address - Street 1:10 NATHAN D PERLMAN PL
Practice Address - Street 2:16TH ST AT 1ST AVENUE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3851
Practice Address - Country:US
Practice Address - Phone:212-844-1808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213233207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01947713Medicaid
NY01947713Medicaid
NY96Y401Medicare ID - Type Unspecified