Provider Demographics
NPI:1871642355
Name:RIZVI, HASAN FAKHRUL (RPH)
Entity Type:Individual
Prefix:MR
First Name:HASAN
Middle Name:FAKHRUL
Last Name:RIZVI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 HALF HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-5863
Mailing Address - Country:US
Mailing Address - Phone:516-987-1521
Mailing Address - Fax:631-243-5968
Practice Address - Street 1:1770D WESTCHESTER AVE # D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-3022
Practice Address - Country:US
Practice Address - Phone:516-987-1521
Practice Address - Fax:718-430-0995
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist