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Individual

DR. PHILIP NIZZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
14 TECHNOLOGY DR, SUITE 10, EAST SETAUKET, NY 11733-3472
(631) 689-5400
(631) 689-8247
Mailing address
14 TECHNOLOGY DR, SUITE 10, EAST SETAUKET, NY 11733-3472
(631) 689-5400
(631) 689-8247

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
211788
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02349264
NY
01
211788
LICENSE
NY
Enumeration date
08/21/2006
Last updated
03/27/2013
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