Provider Demographics
NPI:1770511446
Name:RIZVI, SYED ASGHAR HASSAN (MD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:ASGHAR HASSAN
Last Name:RIZVI
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2 DUDLEY ST
Mailing Address - Street 2:SUITE 530
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3236
Mailing Address - Country:US
Mailing Address - Phone:401-444-3799
Mailing Address - Fax:401-444-2838
Practice Address - Street 1:2 DUDLEY ST
Practice Address - Street 2:SUITE 555
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-3236
Practice Address - Country:US
Practice Address - Phone:401-444-3799
Practice Address - Fax:401-444-2838
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD106972084N0400X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110004918AMedicaid
RI1770511446Medicaid
RIG99274Medicare UPIN