Provider Demographics
NPI:1750451936
Name:IZZO, ALBERT J (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:J
Last Name:IZZO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1580 PELHAM PKWY S
Mailing Address - Street 2:6K
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1112
Mailing Address - Country:US
Mailing Address - Phone:718-920-6626
Mailing Address - Fax:718-798-0730
Practice Address - Street 1:MMC - DEPT OF EMERGENCY MED
Practice Address - Street 2:111 EAST 210TH STREET
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-6626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY239040207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine