Individual provider Active NPI

Liana Crystal Matzen, LPN

  • Licensed Practical Nurse
  • Mastic Beach, NY
National Provider Identifier
1053242255
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
349744 Issued in NY
Practice address
136 Longfellow Dr
Mastic Beach, NY 11951-3016
Phone
(631) 334-9002
NPI assigned
May 27, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 349744 NY Primary

Addresses

Primary practice location

136 Longfellow Dr
Mastic Beach, NY 11951-3016

Mailing address

136 Longfellow Dr
Mastic Beach, NY 11951-3016
Phone (631) 334-9002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
349744NYMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1779840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1053242255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 LONGFELLOW DR",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119513016",
            "telephone_number": "631-334-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 LONGFELLOW DR",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119513016",
            "telephone_number": "631-334-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATZEN",
        "first_name": "LIANA",
        "middle_name": "CRYSTAL",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-27",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "349744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mastic Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.