Provider Demographics
NPI:1134822257
Name:BIZZOCCHI, ALFREDO DANIEL
Entity type:Individual
Prefix:
First Name:ALFREDO
Middle Name:DANIEL
Last Name:BIZZOCCHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 SAXON CT APT D
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-7160
Mailing Address - Country:US
Mailing Address - Phone:773-558-8772
Mailing Address - Fax:
Practice Address - Street 1:1007 GOODYEAR AVE BLDG 1
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1100
Practice Address - Country:US
Practice Address - Phone:256-413-6257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program