Provider Demographics
NPI:1457040156
Name:RIZZO, TYLER (HAD)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:RIZZO
Suffix:
Gender:M
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16841 N 31ST AVE STE 117
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-3029
Mailing Address - Country:US
Mailing Address - Phone:602-843-4844
Mailing Address - Fax:
Practice Address - Street 1:16841 N 31ST AVE STE 117
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-3029
Practice Address - Country:US
Practice Address - Phone:602-843-4844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHADE8359237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist