Provider Demographics
NPI:1487618427
Name:RIZZETTA, ANTHONY J (DO)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:RIZZETTA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EAST NEW YORK AVE.
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-0593
Mailing Address - Country:US
Mailing Address - Phone:609-653-3500
Mailing Address - Fax:609-926-4311
Practice Address - Street 1:1 EAST NEW YORK AVE
Practice Address - Street 2:SHORE PHYSICIANS
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-0000
Practice Address - Country:US
Practice Address - Phone:609-653-3500
Practice Address - Fax:609-926-4311
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB06006800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP01097434OtherRAILROAD MEDICARE
0739807000OtherAMERIHEALTH
1036538OtherHORIZON NJ HEALTH
P380303OtherOXFORD HEALTH PLANS
NJP00730435OtherRR MEDICARE (CAPE)
1980137OtherUNITED HEALTHCARE
NJ6330509Medicaid
NJ152666WXTMedicare PIN
NJP01097434OtherRAILROAD MEDICARE
1036538OtherHORIZON NJ HEALTH
NJ16714-CAPEOtherUHP-NON PAR
1K0925OtherHEALTH NET
F91972Medicare UPIN
110185144OtherMEDICARE RAILROAD
NJP00730435OtherRR MEDICARE (CAPE)
2508705OtherGHI
527948OtherAETNA INC.
NJ152666ZDQ0Medicare PIN
J3933OtherHORIZON BCBS OF NJ
NJ6330509Medicaid