Provider Demographics
NPI:1033838263
Name:RIZZO, GABRIELLA LOUISE (DPT)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:LOUISE
Last Name:RIZZO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 VINCENT DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3929
Mailing Address - Country:US
Mailing Address - Phone:973-632-3025
Mailing Address - Fax:
Practice Address - Street 1:11 EAGLE ROCK AVE
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-3167
Practice Address - Country:US
Practice Address - Phone:973-887-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02115200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist