Provider Demographics
NPI:1699226498
Name:PIZZO, AMY MARIE (LPN)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:MARIE
Last Name:PIZZO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 29
Mailing Address - Street 2:
Mailing Address - City:JOHNSON
Mailing Address - State:NY
Mailing Address - Zip Code:10933-0029
Mailing Address - Country:US
Mailing Address - Phone:845-355-3408
Mailing Address - Fax:
Practice Address - Street 1:59 GREGORY ROAD
Practice Address - Street 2:
Practice Address - City:JOHNSON
Practice Address - State:NY
Practice Address - Zip Code:10933-0029
Practice Address - Country:US
Practice Address - Phone:845-355-3408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY322732-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse