Provider Demographics
NPI:1447604673
Name:RISPOLI, BRIANA (MSED)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:RISPOLI
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:BRIANA
Other - Middle Name:
Other - Last Name:RISPOLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSED
Mailing Address - Street 1:70 MYRNA LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-1626
Mailing Address - Country:US
Mailing Address - Phone:718-744-7458
Mailing Address - Fax:
Practice Address - Street 1:1911 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3913
Practice Address - Country:US
Practice Address - Phone:718-851-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-13
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
NY251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No174400000XOther Service ProvidersSpecialist