Basic Information
| Provider Information | |||||||||
| NPI: | 1487618427 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIZZETTA | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 EAST NEW YORK AVE. | ||||||||
| Address2: | |||||||||
| City: | SOMERS POINT | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082440593 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6096533500 | ||||||||
| FaxNumber: | 6099264311 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 EAST NEW YORK AVE | ||||||||
| Address2: | SHORE PHYSICIANS | ||||||||
| City: | SOMERS POINT | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082440000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6096533500 | ||||||||
| FaxNumber: | 6099264311 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2006 | ||||||||
| LastUpdateDate: | 01/10/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 25MB06006800 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | P01097434 | 01 | NJ | RAILROAD MEDICARE | OTHER | 0739807000 | 01 | AMERIHEALTH | OTHER | 1036538 | 01 | HORIZON NJ HEALTH | OTHER | P380303 | 01 | OXFORD HEALTH PLANS | OTHER | P00730435 | 01 | NJ | RR MEDICARE (CAPE) | OTHER | 1980137 | 01 | UNITED HEALTHCARE | OTHER | 6330509 | 05 | NJ | MEDICAID |