Provider Demographics
NPI:1780707158
Name:RIZZO, MARIA P (LMT)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:P
Last Name:RIZZO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 FAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14223-2708
Mailing Address - Country:US
Mailing Address - Phone:716-913-5628
Mailing Address - Fax:
Practice Address - Street 1:162 MILL ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5549
Practice Address - Country:US
Practice Address - Phone:716-913-5628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008579-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist