Provider Demographics
NPI:1447805528
Name:RIZZI, KAYLA BRIANNE (AUD)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:BRIANNE
Last Name:RIZZI
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 MERRIFIELD AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2912
Mailing Address - Country:US
Mailing Address - Phone:516-965-8441
Mailing Address - Fax:
Practice Address - Street 1:875 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4942
Practice Address - Country:US
Practice Address - Phone:516-931-2977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002870231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist