Provider Demographics
NPI:1457955536
Name:RIZZUTI, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:RIZZUTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 DAKOTA LN
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-1806
Mailing Address - Country:US
Mailing Address - Phone:412-736-5833
Mailing Address - Fax:
Practice Address - Street 1:700 ROUTE 819 S
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-2144
Practice Address - Country:US
Practice Address - Phone:724-547-4563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP452708183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist