Provider Demographics
NPI:1699720466
Name:PIZZARELLO, LOUIS DONALD (MD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:DONALD
Last Name:PIZZARELLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:137 HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11968-4923
Mailing Address - Country:US
Mailing Address - Phone:631-283-5152
Mailing Address - Fax:
Practice Address - Street 1:1228 ROANOKE AVE
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2740
Practice Address - Country:US
Practice Address - Phone:631-727-5265
Practice Address - Fax:631-953-0230
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY138013207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00663938Medicaid
NY00663938Medicaid
NY10A981Medicare PIN