Provider Demographics
NPI:1457503740
Name:RIZK, CRISTINA CHALK (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CRISTINA
Middle Name:CHALK
Last Name:RIZK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:MIRANDA
Other - Last Name:CHALK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10251 N 77TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-1157
Mailing Address - Country:US
Mailing Address - Phone:843-338-6294
Mailing Address - Fax:
Practice Address - Street 1:10251 N 77TH PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-1157
Practice Address - Country:US
Practice Address - Phone:843-338-6294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-17
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1347363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0736PAMedicaid
SCAA3326Medicare UPIN