Provider Demographics
NPI:1396030631
Name:RIZVI, WAQAR AHMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:WAQAR
Middle Name:AHMAD
Last Name:RIZVI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 E JERSEY ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07206-1259
Mailing Address - Country:US
Mailing Address - Phone:908-994-7723
Mailing Address - Fax:908-994-7223
Practice Address - Street 1:2500 METROHEALTH DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109
Practice Address - Country:US
Practice Address - Phone:216-778-4973
Practice Address - Fax:216-778-2397
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2018-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH185332084P0800X
CT541572084P0800X
PAMD4627742084P0800X
NY2919992084P0800X
390200000X
NJ25MA101448002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program