Provider Demographics
NPI:1780057471
Name:RIZZA, OLIVIA (CNA)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:RIZZA
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 166
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06022
Mailing Address - Country:US
Mailing Address - Phone:860-247-8893
Mailing Address - Fax:
Practice Address - Street 1:33 MAIN STREET
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06057
Practice Address - Country:US
Practice Address - Phone:860-247-8893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTNA91291610171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator