Healthcare Provider Details

I. General information

NPI: 1588195200
Provider Name (Legal Business Name): RICHARD ANTHONY PIZZO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2017
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6940 AUSTIN ST
FOREST HILLS NY
11375-4239
US

IV. Provider business mailing address

6940 AUSTIN ST
FOREST HILLS NY
11375-4239
US

V. Phone/Fax

Practice location:
  • Phone: 347-448-5647
  • Fax:
Mailing address:
  • Phone: 347-448-5647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number320356
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: