Provider Demographics
NPI:1427008960
Name:HAMEED, RIZWANULLAH (MD)
Entity Type:Individual
Prefix:
First Name:RIZWANULLAH
Middle Name:
Last Name:HAMEED
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 1:25 BIRCHDALE LN
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-4531
Mailing Address - Country:US
Mailing Address - Phone:718-351-4644
Mailing Address - Fax:
Practice Address - Street 1:585 SCHENECTADY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1809
Practice Address - Country:US
Practice Address - Phone:718-604-5402
Practice Address - Fax:718-363-6647
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185935207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01580767Medicaid
NY185935OtherNEW YORK STATE LICENSE
NY77H632Medicare PIN
NY01580767Medicaid