Provider Demographics
NPI:1114126398
Name:ANTHONY JOSEPH RIZZO DO PC
Entity Type:Organization
Organization Name:ANTHONY JOSEPH RIZZO DO PC
Other - Org Name:ISLANDHEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-666-1956
Mailing Address - Street 1:200 HOWELLS RD
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-5351
Mailing Address - Country:US
Mailing Address - Phone:631-666-1956
Mailing Address - Fax:631-666-1957
Practice Address - Street 1:200 HOWELLS RD
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-5351
Practice Address - Country:US
Practice Address - Phone:631-666-1956
Practice Address - Fax:631-666-1957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225776207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEZ811Medicare PIN
NYH74898Medicare UPIN