MEDICARE: JOSEPH RIZZO

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	156FC0801X	Contact Lens Fitter	008353	NY
2	156FX1800X	Optician	008353	NY

General Provider Information

NPI Number	:	1518346204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH RIZZO

Provider Business Mailing Address
First Line	:	642 SHERIDAN DR
Second Line	:
City	:	TONAWANDA
State	:	NY
Zip	:	14150-7853
Country	:	US
Telephone Number	:	716-695-3733
Fax Number	:

Provider Business Practice Location Address
First Line	:	642 SHERIDAN DR
Second Line	:
City	:	TONAWANDA
State	:	NY
Zip	:	14150-7853
Country	:	US
Telephone Number	:	716-695-3733
Fax Number	:

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

Provider Enumeration Date	:	05/27/2015
Last Update Date	:	05/27/2015

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Directions to “ JOSEPH RIZZO ” Practice Location

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