Provider Demographics
NPI:1003883851
Name:RIZZO, MARIANA RENEE (CNP)
Entity Type:Individual
Prefix:MRS
First Name:MARIANA
Middle Name:RENEE
Last Name:RIZZO
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-2711
Mailing Address - Country:US
Mailing Address - Phone:716-631-8212
Mailing Address - Fax:716-631-8710
Practice Address - Street 1:1835 MAPLE RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-2711
Practice Address - Country:US
Practice Address - Phone:716-631-8212
Practice Address - Fax:716-631-8710
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420598-1363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP73096Medicare UPIN
NYDD4681Medicare ID - Type Unspecified