Individual provider Active NPI

Lisa Ann Vaccarielli, B.S.,LPN

  • Licensed Practical Nurse
  • White Plains, NY
National Provider Identifier
1396874780
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
01804879 Issued in NY
Practice address
505 Central Ave Apt 618
White Plains, NY 10606-1544
Phone
(914) 557-4809
NPI assigned
Mar 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 01804879 NY Primary

Addresses

Primary practice location

505 Central Ave Apt 618
White Plains, NY 10606-1544

Mailing address

505 Central Ave Apt 618
White Plains, NY 10606-1544
Phone (914) 557-4809

Other identifiers 1

IdentifierTypeStateIssuer
01804879MedicaidNY

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
01804879NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396874780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 CENTRAL AVE APT 618",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106061544",
            "telephone_number": "914-557-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 CENTRAL AVE APT 618",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106061544",
            "telephone_number": "914-557-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCARIELLI",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "B.S.,LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "01804879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01804879",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.