MEDICARE: DR. GABRIELLE LIANA RIZZO D.C.

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	111N00000X	Chiropractor	38MC00792600	NJ

General Provider Information

NPI Number	:	1467184549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GABRIELLE LIANA RIZZO D.C.

Provider Business Mailing Address
First Line	:	6 EWING ST
Second Line	:
City	:	BRIDGETON
State	:	NJ
Zip	:	08302-1713
Country	:	US
Telephone Number	:	609-579-2749
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 N PEARL ST
Second Line	:
City	:	BRIDGETON
State	:	NJ
Zip	:	08302-1902
Country	:	US
Telephone Number	:	856-451-4700
Fax Number	:

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

Provider Enumeration Date	:	06/28/2022
Last Update Date	:	06/28/2022

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