Provider Demographics
NPI:1326553033
Name:RICHARD G PIZZANO
Entity Type:Organization
Organization Name:RICHARD G PIZZANO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL ASSIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEISCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-429-2876
Mailing Address - Street 1:135 BLOOMFIELD AVE STE K
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-5902
Mailing Address - Country:US
Mailing Address - Phone:973-429-2876
Mailing Address - Fax:
Practice Address - Street 1:135 BLOOMFIELD AVE STE K
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-5902
Practice Address - Country:US
Practice Address - Phone:973-429-2876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-05
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA024004207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty