Healthcare Provider Details

I. General information

NPI: 1093134918
Provider Name (Legal Business Name): JUDI ANNE RIZZO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 04/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 WOODBRIDGE CT
ROCHESTER NY
14624-4655
US

IV. Provider business mailing address

4 WOODBRIDGE CT
ROCHESTER NY
14624-4655
US

V. Phone/Fax

Practice location:
  • Phone: 585-576-0968
  • Fax:
Mailing address:
  • Phone: 585-576-0968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number660647-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number660647-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: