Provider Demographics
NPI:1992989164
Name:RIZVI, SYMA HASAN (PA)
Entity type:Individual
Prefix:
First Name:SYMA
Middle Name:HASAN
Last Name:RIZVI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1838 GREENE TREE RD STE 135
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-7108
Mailing Address - Country:US
Mailing Address - Phone:443-471-0467
Mailing Address - Fax:
Practice Address - Street 1:1838 GREENE TREE RD STE 135
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-7108
Practice Address - Country:US
Practice Address - Phone:443-471-0467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0003654363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant