Provider Demographics
NPI:1508043787
Name:RIZZO, GERALD LEE (RPH)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:LEE
Last Name:RIZZO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 DOUGLAS PL
Mailing Address - Street 2:
Mailing Address - City:EASTCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10709-2703
Mailing Address - Country:US
Mailing Address - Phone:914-961-4387
Mailing Address - Fax:
Practice Address - Street 1:114 PONDFIELD RD
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-3901
Practice Address - Country:US
Practice Address - Phone:914-961-6196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY23605183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist