Provider Demographics
NPI:1619190964
Name:RIZZO, ERLINDA SALCEDO (BSMT)
Entity type:Individual
Prefix:MRS
First Name:ERLINDA
Middle Name:SALCEDO
Last Name:RIZZO
Suffix:
Gender:F
Credentials:BSMT
Other - Prefix:MRS
Other - First Name:ERLINDA
Other - Middle Name:SALCEDO
Other - Last Name:RIZZO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BSMT
Mailing Address - Street 1:33 BOWERY STE B205
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-6745
Mailing Address - Country:US
Mailing Address - Phone:212-431-4200
Mailing Address - Fax:212-625-9338
Practice Address - Street 1:33 BOWERY STE B205
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-6745
Practice Address - Country:US
Practice Address - Phone:212-431-4200
Practice Address - Fax:212-625-9338
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
L21471Medicare ID - Type UnspecifiedLABORATORY