Provider Demographics
NPI:1952590424
Name:JOSEPH A. IZZI M.D., INC.
Entity Type:Organization
Organization Name:JOSEPH A. IZZI M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPAEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:IZZI
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:401-353-5550
Mailing Address - Street 1:1351 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02911-3340
Mailing Address - Country:US
Mailing Address - Phone:401-353-5550
Mailing Address - Fax:401-353-2909
Practice Address - Street 1:1351 SMITH ST
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02911-3340
Practice Address - Country:US
Practice Address - Phone:401-353-5550
Practice Address - Fax:401-353-2909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI3690174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI001100OtherBLUE CHIP
RI09-00203OtherUNITED HEALTH
RI0000002052OtherBLUE CROSS
RI3690OtherSTATE LICENSE
RI09-00203OtherUNITED HEALTH