Provider Demographics
NPI:1346704699
Name:ROCHA DE ALMEIDA BIZZO, RENATA (MD, MSC, PHD)
Entity Type:Individual
Prefix:
First Name:RENATA
Middle Name:
Last Name:ROCHA DE ALMEIDA BIZZO
Suffix:
Gender:F
Credentials:MD, MSC, PHD
Other - Prefix:
Other - First Name:RENATA
Other - Middle Name:
Other - Last Name:ROCHA DE ALMEIDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 EMERSON PL APT 23A
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2238
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA2788352085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program