Mackenzie Robert Livermore

Primary specialty

Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X

License

25MT00272900 Issued in NJ

Practice address

1 Felician Way
Rutherford, NJ 07070-1977

Phone

(908) 752-7127

NPI assigned

Oct 17, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1356983787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 HOOK DR",
            "city": "MILFORD",
            "state": "NJ",
            "postal_code": "088481539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FELICIAN WAY",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070701977",
            "telephone_number": "908-752-7127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVERMORE",
        "first_name": "MACKENZIE",
        "middle_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "NJ",
            "license": "25MT00272900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Langer, D.D.S.
• Clive Ka Lee, ATC
• Jin S Lee, M.D.
• Marie R Levine, OD
• Brian Lilien
• Divina Elizabeth Lopez, M.D.
• Jenny Marlene Lorenzo, DMD
• Olga Lorenzo, DMD
• George J Lubertazzo, D.C.
• Paulina Luczaj, BCBA

• All providers in Rutherford, NJ
• Sports Medicine (Emergency Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; 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.