MEDICARE: MR. NICHOLAS VERLIZZO RPL

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	183500000X	Pharmacist	032803	NY

General Provider Information

NPI Number	:	1588669824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NICHOLAS VERLIZZO RPL

Provider Business Mailing Address
First Line	:	143 FOSHAY AVE
Second Line	:
City	:	PLEASANTVILLE
State	:	NY
Zip	:	10570-3617
Country	:	US
Telephone Number	:	914-747-3669
Fax Number	:

Provider Business Practice Location Address
First Line	:	973 MCLEAN AVE
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10704-4108
Country	:	US
Telephone Number	:	914-237-8821
Fax Number	:	914-237-0716

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	07/08/2007

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