Provider Demographics
NPI:1619157955
Name:RIZZITIELLO, JEANMARIE MARGARET (RN)
Entity Type:Individual
Prefix:MRS
First Name:JEANMARIE
Middle Name:MARGARET
Last Name:RIZZITIELLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980-1513
Mailing Address - Country:US
Mailing Address - Phone:845-558-8031
Mailing Address - Fax:
Practice Address - Street 1:32 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:STONY POINT
Practice Address - State:NY
Practice Address - Zip Code:10980-1513
Practice Address - Country:US
Practice Address - Phone:845-558-8031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-04
Last Update Date:2007-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334389-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01279794Medicaid