Provider Demographics
NPI:1992712962
Name:RIZZI, ANGELO VICTOR (RPA C)
Entity type:Individual
Prefix:
First Name:ANGELO
Middle Name:VICTOR
Last Name:RIZZI
Suffix:
Gender:M
Credentials:RPA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 11
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3472
Mailing Address - Country:US
Mailing Address - Phone:631-444-1496
Mailing Address - Fax:631-444-7671
Practice Address - Street 1:14 TECHNOLOGY DR
Practice Address - Street 2:SUITE 11
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3472
Practice Address - Country:US
Practice Address - Phone:631-444-1496
Practice Address - Fax:631-444-7671
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0071781363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical