Provider Demographics
NPI:1760594410
Name:RIZZO, ROSALINA B (LCSW-R)
Entity Type:Individual
Prefix:
First Name:ROSALINA
Middle Name:B
Last Name:RIZZO
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEDAILLE COLLEGE
Mailing Address - Street 2:18 AGASSIZ CIRCLE
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214
Mailing Address - Country:US
Mailing Address - Phone:716-880-2339
Mailing Address - Fax:716-880-3399
Practice Address - Street 1:MEDAILLE COLLEGE
Practice Address - Street 2:18 AGASSIZ CIRCLE
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214
Practice Address - Country:US
Practice Address - Phone:716-880-2339
Practice Address - Fax:716-880-3399
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0711591104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06523OtherMEDICARE UNSPECIFIED
NY00357497Medicaid
NY08494418Medicaid
NY06523OtherMEDICARE UNSPECIFIED