Provider Demographics
NPI:1003098302
Name:LOUIS RIZIO III MD PA
Entity Type:Organization
Organization Name:LOUIS RIZIO III MD PA
Other - Org Name:SPORTS MEDICINE & ORTHOPAEDIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZIO
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:973-758-1078
Mailing Address - Street 1:349 E NORTHFIELD RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4802
Mailing Address - Country:US
Mailing Address - Phone:973-758-1078
Mailing Address - Fax:973-758-1079
Practice Address - Street 1:349 E NORTHFIELD RD
Practice Address - Street 2:SUITE 120
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4802
Practice Address - Country:US
Practice Address - Phone:973-758-1078
Practice Address - Fax:973-758-1079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty