Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 25MA08922900 | NJ |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | L-236339 | MA |
N | 2081P2900X | Pain Medicine | 25MA08922900 | NJ |
N | 2081S0010X | Sports Medicine | 25MA08922900 | NJ |
N | 213ES0000X | Sports Medicine | 25MA08922900 | NJ |
NPI | 1477717791 |
---|---|
Provider Name | Michael H. Rizkalla |
First Address | Bordentown, NJ 08505-2251 |
Second Address | Bordentown, NJ 08505-2251 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2008 |
Last Update Date | 23/09/2014 |