Healthcare Provider Details

I. General information

NPI: 1952839649
Provider Name (Legal Business Name): STEVEN C. TIZIO MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2017
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1706 CORLIES AVE SUITE S
NEPTUNE NJ
07753-4977
US

IV. Provider business mailing address

PO BOX 277
NEPTUNE NJ
07754-0277
US

V. Phone/Fax

Practice location:
  • Phone: 732-450-1500
  • Fax: 732-450-1555
Mailing address:
  • Phone: 732-450-1500
  • Fax: 732-450-1555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25MA09473600
License Number StateNJ

VIII. Authorized Official

Name: STEVEN C. TIZIO MD
Title or Position: PRESIDENT
Credential: MD
Phone: 732-775-5005