Provider Demographics
NPI:1942812136
Name:PRIZZIO, GINA MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:PRIZZIO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 PINERIDGE LN
Mailing Address - Street 2:
Mailing Address - City:POWHATAN
Mailing Address - State:VA
Mailing Address - Zip Code:23139-5031
Mailing Address - Country:US
Mailing Address - Phone:804-901-4438
Mailing Address - Fax:
Practice Address - Street 1:9000 STAPLES MILL RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-2021
Practice Address - Country:US
Practice Address - Phone:804-977-9515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202218939183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist