Provider Demographics
NPI:1417968348
Name:RIZK, YVONNE RIFAAT (MD)
Entity Type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:RIFAAT
Last Name:RIZK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 PARAMOUNT DR
Mailing Address - Street 2:
Mailing Address - City:RAYNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02767-5416
Mailing Address - Country:US
Mailing Address - Phone:508-880-0012
Mailing Address - Fax:866-262-4460
Practice Address - Street 1:675 PARAMOUNT DR
Practice Address - Street 2:
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767-5416
Practice Address - Country:US
Practice Address - Phone:508-880-0012
Practice Address - Fax:866-262-4460
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75120207ZP0101X, 207ZP0105X, 2084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ25484OtherBCBS
F50120Medicare UPIN
MAJ25484OtherBCBS