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General NPI Number Information
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NPI Number | 1326113804
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Entity Type | Individual
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Provider Name | NICHOLAS RIZZITELLO DC
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Gender | Male
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 1200 CLINTON AVE SUITE 100
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City | IRVINGTON
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State | NJ
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Zip | 07111
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Country | US
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Telephone | 973-374-2456
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Fax | 973-374-0708
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Provider Business Mailing Address
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Address Line | 1200 CLINTON AVE SUITE 100
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City | IRVINGTON
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State | NJ
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Zip | 07111
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Country | US
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Telephone | 973-374-2456
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Fax | 973-374-0708
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 38MC00159000
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License Number State | NJ
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