Provider Demographics
NPI:1639624505
Name:RIZZI, RACHEL (LAC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:RIZZI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 290
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-3403
Mailing Address - Country:US
Mailing Address - Phone:215-559-4655
Mailing Address - Fax:
Practice Address - Street 1:455 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 290
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-3403
Practice Address - Country:US
Practice Address - Phone:215-559-4655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA#AK001043171100000X
NJ25MZ00055900171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist