Provider Demographics
NPI:1588756415
Name:RIZZO, PETER FOLEY (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:FOLEY
Last Name:RIZZO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 PONDFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-3809
Mailing Address - Country:US
Mailing Address - Phone:914-337-1118
Mailing Address - Fax:914-337-1129
Practice Address - Street 1:77 PONDFIELD RD
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-3809
Practice Address - Country:US
Practice Address - Phone:914-337-1118
Practice Address - Fax:914-337-1129
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185062-1207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
200015069OtherMEDICARE RAILROAD
NY01460113Medicaid
NYPR070K1110OtherEMPIRE BLUE CROSS BLUE SHIELD
NY01460113Medicaid
NY70K111Medicare PIN