Individual provider Active NPI

Evon T Rizkalla, RPH

  • Pharmacist
  • New York, NY
National Provider Identifier
1053646109
Registry record updated Oct 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
34245 Issued in NY
Practice address
1111 Amsterdam Ave
Outpatient Pharmacy -Morningside Clinic
New York, NY 10025-1716
Phone
(212) 636-1122
NPI assigned
Oct 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 34245 NY Primary

Addresses

Primary practice location

1111 Amsterdam Ave
Outpatient Pharmacy -Morningside Clinic
New York, NY 10025-1716

Mailing address

1111 Amsterdam Ave
Outpatient Pharmacy-Morningside
New York, NY 10025-1716
Phone (212) 636-1122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
34245NYMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254960000000",
    "number": "1053646109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "address_2": "OUTPATIENT PHARMACY-MORNINGSIDE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716",
            "telephone_number": "212-636-1122",
            "fax_number": "212-636-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "address_2": "OUTPATIENT PHARMACY -MORNINGSIDE CLINIC",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716",
            "telephone_number": "212-636-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZKALLA",
        "first_name": "EVON",
        "middle_name": "T",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-07",
        "last_updated": "2009-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "34245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.