MEDICARE: MRS. ERLINDA SALCEDO RIZZO BSMT

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	246QM0706X	Medical Technologist		NY

General Provider Information

NPI Number	:	1619190964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERLINDA SALCEDO RIZZO BSMT

Provider Business Mailing Address
First Line	:	33 BOWERY STE B205
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10002-6745
Country	:	US
Telephone Number	:	212-431-4200
Fax Number	:	212-625-9338

Provider Business Practice Location Address
First Line	:	33 BOWERY STE B205
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10002-6745
Country	:	US
Telephone Number	:	212-431-4200
Fax Number	:	212-625-9338

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

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	07/08/2007

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