Provider Demographics
NPI:1467670117
Name:RIZZO, EUN KYONG (PT)
Entity Type:Individual
Prefix:MRS
First Name:EUN KYONG
Middle Name:
Last Name:RIZZO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 RED SCHOOL LN
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-2276
Mailing Address - Country:US
Mailing Address - Phone:908-859-2800
Mailing Address - Fax:
Practice Address - Street 1:290 RED SCHOOL LN
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-2276
Practice Address - Country:US
Practice Address - Phone:908-859-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01226300225100000X
MA15574225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist