Healthcare Provider Details

I. General information

NPI: 1497097802
Provider Name (Legal Business Name): RICHARD FERRARIZ TIZON PHARM.D, BCOP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2013
Last Update Date: 03/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 YORK AVE
NEW YORK NY
10065-6007
US

IV. Provider business mailing address

520 E 81ST ST APT 4F
NEW YORK NY
10028-7040
US

V. Phone/Fax

Practice location:
  • Phone: 212-639-2170
  • Fax:
Mailing address:
  • Phone: 609-220-2163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number20 053121
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: