Lisa Marie Indelicato, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02471800 Issued in NJ

Practice address

300 2ND Ave
Long Branch, NJ 07740-6303

Phone

(732) 923-6585

NPI assigned

May 31, 2011

Sex

Female

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

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306800000000",
    "number": "1396039087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 SPRING ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103041428",
            "telephone_number": "718-757-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 2ND AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406303",
            "telephone_number": "732-923-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDELICATO",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-31",
        "last_updated": "2011-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02471800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saif Hossain, M.D.
• Christine Hsu, MD
• Susan Marie Hudome, MD
• Aubrey Burr Hunt, LCSW, LCADC
• Syed Hussain, MD
• Integrity Health LLC
• Irina Vilenskaya MD PC
• Irving D Strouse MD PA
• Julie H Isaacson, M.D.
• Anora Isayeva, DDS

• Dentist in Long Branch, NJ
• Providers in Long Branch, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.