Provider Demographics
NPI:1477173599
Name:IZZO, CAROLINE MARINA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:MARINA
Last Name:IZZO
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:41 MOURNING DOVE DR
Mailing Address - Street 2:
Mailing Address - City:SAUNDERSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02874-2210
Mailing Address - Country:US
Mailing Address - Phone:401-523-5367
Mailing Address - Fax:
Practice Address - Street 1:1407 S COUNTY TRL STE 430A
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1679
Practice Address - Country:US
Practice Address - Phone:401-886-7910
Practice Address - Fax:401-886-7913
Is Sole Proprietor?:No
Enumeration Date:2020-04-18
Last Update Date:2024-03-26
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant