Provider Demographics
NPI:1982474219
Name:RIZZUTO, SOPHIA (RD, CDN)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:RIZZUTO
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 HIGH POINT DR APT 511
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1167
Mailing Address - Country:US
Mailing Address - Phone:914-703-2151
Mailing Address - Fax:
Practice Address - Street 1:500 HIGH POINT DR APT 511
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1167
Practice Address - Country:US
Practice Address - Phone:914-703-2151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011271133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered