MEDICARE: SHELLIE J RIZZA NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F335949	NY

General Provider Information

NPI Number	:	1336471937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELLIE J RIZZA NP

Provider Business Mailing Address
First Line	:	202 WALTON ST STE 200
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13202-1373
Country	:	US
Telephone Number	:	315-882-0795
Fax Number	:

Provider Business Practice Location Address
First Line	:	202 WALTON ST STE 200
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13202-1373
Country	:	US
Telephone Number	:	315-882-0795
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2010
Last Update Date	:	11/13/2023

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