Individual provider Active NPI

Lance Allen Liotta, M.D., PH.D.

  • Clinical Medical Laboratory
  • Bethesda, MD
National Provider Identifier
1134458391
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
D21975 Issued in MD
Practice address
8601 Bradley Blvd
Bethesda, MD 20817-2602
Phone
(301) 775-1336
NPI assigned
Dec 17, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X D21975 MD Primary

Addresses

Primary practice location

8601 Bradley Blvd
Bethesda, MD 20817-2602

Mailing address

8601 Bradley Blvd
Bethesda, MD 20817-2602
Phone (301) 775-1336

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
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
D21975MDMDClinical Medical Laboratory

NPI Registry JSON

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261008000000",
    "number": "1134458391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8601 BRADLEY BLVD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208172602",
            "telephone_number": "301-775-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 BRADLEY BLVD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208172602",
            "telephone_number": "301-775-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIOTTA",
        "first_name": "LANCE",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-17",
        "last_updated": "2009-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MD",
            "license": "D21975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; 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.