Provider Demographics
NPI:1588669824
Name:VERLIZZO, NICHOLAS (RPL)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:
Last Name:VERLIZZO
Suffix:
Gender:M
Credentials:RPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 FOSHAY AVE
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-3617
Mailing Address - Country:US
Mailing Address - Phone:914-747-3669
Mailing Address - Fax:
Practice Address - Street 1:973 MCLEAN AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-4108
Practice Address - Country:US
Practice Address - Phone:914-237-8821
Practice Address - Fax:914-237-0716
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032803183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist