Healthcare Provider Details

I. General information

NPI: 1558099531
Provider Name (Legal Business Name): BRIGITTE RIZZO NURSE PRACTITIONER IN ADULT HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 OLD COUNTRY RD
PLAINVIEW NY
11803-4929
US

IV. Provider business mailing address

4 MILLENNIUM CT
BOHEMIA NY
11716-2202
US

V. Phone/Fax

Practice location:
  • Phone: 516-513-0616
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: BRIGITTE RIZZO
Title or Position: PRESIDENT
Credential: NP
Phone: 631-708-6676