Individual provider Active NPI

Jennifer Lisimachio, IBCLC

  • Lactation Consultant (Non-RN)
  • Jersey City, NJ
National Provider Identifier
1417228750
Registry record updated May 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
11197443 Issued in NJ
Practice address
320 1/2 Webster Ave
Jersey City, NJ 07307-1177
Phone
(917) 312-5700
NPI assigned
Jan 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X 11197443 NJ Primary

Addresses

Primary practice location

320 1/2 Webster Ave
Jersey City, NJ 07307-1177

Mailing address

320 1/2 Webster Ave
Jersey City, NJ 07307-1177
Phone (917) 312-5700

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

LicenseStateTypeSpecialty
11197443NJMDLactation Consultant (Non-RN)

NPI Registry JSON

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368489600000",
    "number": "1417228750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 1/2 WEBSTER AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073071177",
            "telephone_number": "917-312-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 1/2 WEBSTER AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073071177",
            "telephone_number": "917-312-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISIMACHIO",
        "first_name": "JENNIFER",
        "credential": "IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-18",
        "last_updated": "2013-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "NJ",
            "license": "11197443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; 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.