Provider Demographics
NPI:1639630288
Name:RIZZUTI, MADELINE (RDN, CDE)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:RIZZUTI
Suffix:
Gender:F
Credentials:RDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 PARK PL APT 3B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4671
Mailing Address - Country:US
Mailing Address - Phone:631-418-4018
Mailing Address - Fax:
Practice Address - Street 1:461 PARK PL APT 3B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-4671
Practice Address - Country:US
Practice Address - Phone:631-418-4018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered