Active NPI
Lavizan Baldev
- Pediatric Registered Nurse
- Port Jefferson Station, NY
National Provider Identifier
1346408143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Registered Nurse
- License
- 536970-1
- Practice address
- 9 Norton Ave
Port Jefferson Station, NY 11776-4407 - Phone
- (631) 474-7878
- NPI assigned
- May 28, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Registered Nurse | 163WP0200X | 536970-1 | NY | Primary |
Addresses
Primary practice location
9 Norton Ave
Port Jefferson Station, NY 11776-4407
Mailing address
8 Esther CT
Patchogue, NY 11772-1814
Phone (631) 289-5797
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DU32484Y | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 536970-1 | NY | MD | Pediatric Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211932800000",
"number": "1346408143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 ESTHER CT",
"city": "PATCHOGUE",
"state": "NY",
"postal_code": "117721814",
"telephone_number": "631-289-5797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 NORTON AVE",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117764407",
"telephone_number": "631-474-7878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALDEV",
"first_name": "LAVIZAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-28",
"last_updated": "2008-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pediatrics",
"state": "NY",
"license": "536970-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DU32484Y",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson Station, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.