Izzo, Steven R

Izzo, Steven R is an sole proprietor health care provider with primary practice located at 6853 Fresh Pond Rd , Ridgewood NY 11385-5263. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Izzo, Steven R can be contacted via phone (718) 821-2545.

Contact Information

Primary practice address
6853 Fresh Pond Rd Ridgewood NY 11385-5263
Phone: (718) 821-2545
Fax: (718) 418-2809
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 042245 New York

Profile Details

NPI number 1750379699
LBN Legal business name Izzo, Steven R
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 13th, 2005
Last updated Feb 16th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750379699 NPPES
New York MEDICAID 01594536

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