Provider Demographics
NPI:1740316504
Name:RIZZO MEDICAL ASSOCIATES LLC
Entity type:Organization
Organization Name:RIZZO MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-890-1217
Mailing Address - Street 1:45 REINERS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-2327
Mailing Address - Country:US
Mailing Address - Phone:973-890-1217
Mailing Address - Fax:973-890-9282
Practice Address - Street 1:1 BROADWAY
Practice Address - Street 2:SUITE 105
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-1842
Practice Address - Country:US
Practice Address - Phone:201-797-3636
Practice Address - Fax:201-794-9229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8195501Medicaid
NJ036286Medicare PIN