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Individual

KENNETH L IZZO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1811 BETHLEHEM PIKE, SUITE 221, FLOURTOWN, PA 19031
(215) 233-1223
(215) 233-1141
Mailing address
1811 BETHLEHEM PIKE, SUITE 221, FLOURTOWN, PA 19031
(215) 233-1223
(215) 233-1141

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
MD017101
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0060080000
BCBS KEYSTONE EAST
05
01927385
PA
01
3503051
AETNA
PA
01
IZ112248
BCBS PERSONAL CHOICE
PA
Enumeration date
09/27/2006
Last updated
07/08/2007
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