Provider Demographics
NPI:1659563922
Name:R ENDOCRINOLOGY INC
Entity Type:Organization
Organization Name:R ENDOCRINOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WIJAH
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-585-4267
Mailing Address - Street 1:PO BOX 880
Mailing Address - Street 2:
Mailing Address - City:PRINCETON JCT
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-0880
Mailing Address - Country:US
Mailing Address - Phone:609-585-4267
Mailing Address - Fax:609-585-4269
Practice Address - Street 1:1374 WHITEHORSE HAMILTON SQUARE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3701
Practice Address - Country:US
Practice Address - Phone:609-585-4267
Practice Address - Fax:609-585-4269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06073500207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0032042Medicaid
NJ070156Medicare PIN
NJ0032042Medicaid
NJG00310Medicare UPIN