Provider Demographics
NPI:1891852877
Name:RIZZO, DENISE RITA (APRN-C)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:RITA
Last Name:RIZZO
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:MS
Other - First Name:DENISE
Other - Middle Name:RITA
Other - Last Name:MONAGHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:272 VREELAND AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1662
Mailing Address - Country:US
Mailing Address - Phone:201-444-7488
Mailing Address - Fax:201-444-7488
Practice Address - Street 1:625 N MAPLE AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1589
Practice Address - Country:US
Practice Address - Phone:201-444-7488
Practice Address - Fax:201-444-7488
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC08058900363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ203420741OtherFED TAX ID
NJ26NC08058900OtherADV.PRACTICE NURSE LIC.