Provider Demographics
NPI:1912659269
Name:CALA RIZO, OLGA MERCEDES (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:OLGA
Middle Name:MERCEDES
Last Name:CALA RIZO
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:1105 LAUREL OAK RD STE 165
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4312
Practice Address - Country:US
Practice Address - Phone:856-374-4440
Practice Address - Fax:856-325-5734
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-18
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01263500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NJ01263500OtherNJ BON
NJ26NR19771000OtherNJ BON