Provider Demographics
NPI:1235137480
Name:RIZZO, BRIGITTE ROCHE (NP)
Entity Type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:ROCHE
Last Name:RIZZO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4929
Mailing Address - Country:US
Mailing Address - Phone:516-513-0616
Mailing Address - Fax:516-513-0617
Practice Address - Street 1:750 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4929
Practice Address - Country:US
Practice Address - Phone:516-513-0616
Practice Address - Fax:516-513-0617
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF303681-1363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ20353Medicare UPIN
0592G1Medicare ID - Type Unspecified