Provider Demographics
NPI:1285819557
Name:RIZZO, ROSEMARY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROSEMARY
Middle Name:
Last Name:RIZZO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 ISABELLA CT
Mailing Address - Street 2:
Mailing Address - City:EAST GREENBUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12061-3402
Mailing Address - Country:US
Mailing Address - Phone:518-813-9181
Mailing Address - Fax:518-813-9181
Practice Address - Street 1:1300 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-1628
Practice Address - Country:US
Practice Address - Phone:518-268-5507
Practice Address - Fax:518-268-5778
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036971183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY036971Medicaid