Provider Demographics
NPI:1942081690
Name:RIZZOTTI, YULIA
Entity Type:Individual
Prefix:
First Name:YULIA
Middle Name:
Last Name:RIZZOTTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YULIA
Other - Middle Name:
Other - Last Name:TSYBIKOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 RICHMOND TER APT 6T
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-1527
Mailing Address - Country:US
Mailing Address - Phone:347-681-2475
Mailing Address - Fax:
Practice Address - Street 1:355 BARD AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-1664
Practice Address - Country:US
Practice Address - Phone:347-681-2475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY669696367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered