Active NPI
Francesca Licandro, M.D.
- Student in an Organized Health Care Education/Training Program
- Newark, NJ
National Provider Identifier
1063094928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 185 S Orange Ave
Newark, NJ 07103-2757 - Phone
- (973) 972-7837
- NPI assigned
- Apr 21, 2021
- Reactivated
- Jun 3, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
185 S Orange Ave
Newark, NJ 07103-2757
Mailing address
2401 W Belvedere Avenue
Medical Education Office
Baltimore, MD 21215
Phone (410) 601-7649
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210915001228 | MD | Order and Referring Only - Internal Medicine | 5294131355 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718409600000",
"number": "1063094928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 W BELVEDERE AVENUE",
"address_2": "MEDICAL EDUCATION OFFICE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21215",
"telephone_number": "410-601-7649",
"fax_number": "410-601-7649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 S ORANGE AVE",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071032757",
"telephone_number": "973-972-7837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICANDRO",
"first_name": "FRANCESCA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-21",
"last_updated": "2024-06-15",
"certification_date": "2024-06-15",
"deactivation_date": "2022-03-02",
"reactivation_date": "2022-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.