Provider Demographics
NPI:1588175731
Name:RIZZI, ALICE BORODIANSKY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:BORODIANSKY
Last Name:RIZZI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:
Other - Last Name:BORODIANSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:620 WILSON AVE # 504
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-2175
Mailing Address - Country:US
Mailing Address - Phone:201-685-0658
Mailing Address - Fax:
Practice Address - Street 1:620 WILSON AVE # 504
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-2175
Practice Address - Country:US
Practice Address - Phone:201-685-0658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-16
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022909103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist