Healthcare Provider Details

I. General information

NPI: 1669415717
Provider Name (Legal Business Name): MICHAEL A RIZZI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MOUNT KISCO MEDICAL GROUP, PC 1825 COMMERCE STREET
YORKTOWN HEIGHTS NY
10598-4432
US

IV. Provider business mailing address

110 SOUTH BEDFORD ROAD MOUNT KISCO MEDICAL GROUP, PC
MOUNT KISCO NY
10549-3446
US

V. Phone/Fax

Practice location:
  • Phone: 914-241-1050
  • Fax: 914-962-0527
Mailing address:
  • Phone: 914-241-1050
  • Fax: 914-962-0527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number200829
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: