Provider Demographics
NPI:1447520242
Name:BRIZZI, ROLANDO (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:ROLANDO
Middle Name:
Last Name:BRIZZI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:MR
Other - First Name:ROLANDO
Other - Middle Name:
Other - Last Name:BRIZZI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:31 KELLY ST
Mailing Address - Street 2:PO BX 48
Mailing Address - City:RHINECLIFF
Mailing Address - State:NY
Mailing Address - Zip Code:12574
Mailing Address - Country:US
Mailing Address - Phone:845-876-2268
Mailing Address - Fax:
Practice Address - Street 1:4103 ATATE RT 28
Practice Address - Street 2:474
Practice Address - City:BOICEVILLE
Practice Address - State:NY
Practice Address - Zip Code:12421
Practice Address - Country:US
Practice Address - Phone:845-657-6511
Practice Address - Fax:845-657-9854
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist