Individual
DR. STEVEN R IZZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6853 FRESH POND RD, RIDGEWOOD, NY 11385-5263
(718) 821-2545
(718) 418-2809
Mailing address
6853 FRESH POND RD, RIDGEWOOD, NY 11385-5263
(718) 821-2545
(718) 418-2809
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
042245
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01594536
—
NY
Enumeration date
10/13/2005
Last updated
02/16/2012
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