Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 38MC00159000 | NJ |
NPI | 1326113804 |
---|---|
Provider Name | Dr. Nicholas Rizzitello |
First Address | Irvington, NJ 07111 |
Second Address | Irvington, NJ 07111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 27/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1385208 | (05) | NJ |
T45206 | (02) | NJ |