Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 230421 | NY |
NPI | 1083645535 |
---|---|
Provider Name | Dr. Christopher J Rizzo |
First Address | Glenville, NY 12302-4523 |
Second Address | Glenville, NY 12302-4523 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 27/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1538180351 | (05) | NY |
I03678 | (02) | NY |