Provider Demographics
NPI:1053646752
Name:RIZZO, DAVID (MS, PT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:RIZZO
Suffix:
Gender:M
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 GREENTREE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1115
Mailing Address - Country:US
Mailing Address - Phone:856-751-1937
Mailing Address - Fax:856-751-1938
Practice Address - Street 1:1919 GREENTREE RD
Practice Address - Street 2:SUITE C
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1115
Practice Address - Country:US
Practice Address - Phone:856-751-1937
Practice Address - Fax:856-751-1938
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00752900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist