Provider Demographics
NPI:1609251404
Name:RIZZO, MARISA
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:RIZZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1736 PARVIN MILL RD
Mailing Address - Street 2:
Mailing Address - City:PITTSGROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:08318-4556
Mailing Address - Country:US
Mailing Address - Phone:856-305-8948
Mailing Address - Fax:
Practice Address - Street 1:1736 PARVIN MILL RD
Practice Address - Street 2:
Practice Address - City:PITTSGROVE
Practice Address - State:NJ
Practice Address - Zip Code:08318-4556
Practice Address - Country:US
Practice Address - Phone:856-305-8948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program