Healthcare Provider Details

I. General information

NPI: 1881690071
Provider Name (Legal Business Name): ALBERT J RIZZOLI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 BUENA VISTA DR SE
ALBUQUERQUE NM
87106-4261
US

IV. Provider business mailing address

11001 HOLLY AVE NE
ALBUQUERQUE NM
87122-3123
US

V. Phone/Fax

Practice location:
  • Phone: 505-923-5709
  • Fax: 505-923-6157
Mailing address:
  • Phone: 505-923-5709
  • Fax: 505-923-6157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number77-243
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: