Andrea E Revoredo

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

26NP49612000 Issued in NJ

Practice address

971 US Highway 9 Apt 2-M
Parlin, NJ 08859-2002

Phone

(732) 670-8736

NPI assigned

Jun 6, 2023

Sex

Female

Sole proprietor

No

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": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1376237149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 US HIGHWAY 9 APT 2-M",
            "city": "PARLIN",
            "state": "NJ",
            "postal_code": "088592002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 US HIGHWAY 9 APT 2-M",
            "city": "PARLIN",
            "state": "NJ",
            "postal_code": "088592002",
            "telephone_number": "732-670-8736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVOREDO",
        "first_name": "ANDREA",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NJ",
            "license": "26NP49612000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giovanni Quinones, PT/DPT
• Abayomi Ramos, P.T
• Venita Rawal, LPC
• Syeda Shehrbano Raza
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• Jhonel Richards
• Rite Aid of New Jersey Inc
• Jackelyn Rodriguez Lugo, FNP-C
• Eric Thomas Rodriguez
• Royal Aquarius Empire

• Licensed Practical Nurse in Parlin, NJ
• Providers in Parlin, NJ by specialty
• Licensed Practical Nurse in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.