Jaclyn Lasita, RN, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F383584 Issued in NY

Practice address

263 Blue Point Ave
Blue Point, NY 11715-1224

Phone

(631) 419-6737

NPI assigned

Jun 26, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1235790577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 TARPON RD",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117789579",
            "telephone_number": "631-740-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 BLUE POINT AVE",
            "city": "BLUE POINT",
            "state": "NY",
            "postal_code": "117151224",
            "telephone_number": "631-419-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASITA",
        "first_name": "JACLYN",
        "credential": "RN, PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "745257",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NY",
            "license": "745257",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F383584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan C Krause, MS SPECIAL EDUCATION
• Alyssa Krisa
• Ethan David Kupferberg
• Carole Anne Lambert, RN
• Ellen Lasalle, RN
• Colleen Laskowitz, RN
• Latchology Li LLC
• Janet Lee Lau, LCSW
• Mathew Lauchner
• Latoya Lawson, LPN

• Pediatric Nurse Practitioner in Blue Point, NY
• Providers in Blue Point, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.