Provider Demographics
NPI:1821527995
Name:RIZWAN, MARVI (MD)
Entity Type:Individual
Prefix:DR
First Name:MARVI
Middle Name:
Last Name:RIZWAN
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 1:25 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:516-423-9762
Mailing Address - Fax:
Practice Address - Street 1:5 CUBA HILL RD
Practice Address - Street 2:
Practice Address - City:GREENLAWN
Practice Address - State:NY
Practice Address - Zip Code:11740-1624
Practice Address - Country:US
Practice Address - Phone:631-628-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-12
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY325336207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology