Provider Demographics
NPI:1619061322
Name:RIZZUTO, CHARLES (MSW)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:
Last Name:RIZZUTO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 N PLEASANT ST
Mailing Address - Street 2:#201
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1738
Mailing Address - Country:US
Mailing Address - Phone:413-230-3751
Mailing Address - Fax:
Practice Address - Street 1:48 N PLEASANT ST
Practice Address - Street 2:#201
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-1738
Practice Address - Country:US
Practice Address - Phone:413-230-3751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2011-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1138921041C0700X
NYR-039917-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1619061322Medicare PIN