Reanna Sade Lizardo

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

340 Kingsland St
Nutley, NJ 07110-1150

Phone

(973) 761-9000

NPI assigned

Jan 31, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1417600438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 E 8TH ST APT C6",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112184258",
            "telephone_number": "347-554-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 KINGSLAND ST",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101150",
            "telephone_number": "973-761-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZARDO",
        "first_name": "REANNA",
        "middle_name": "SADE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifequest Ambulance Services
• Ligaya Prystowsky MD PC
• Dominick Ligresti I, M.D.
• Felix A Linfante, LPC
• Barry J. Litwin, DDS
• Mahmoud Loghman-Adham, M.D.
• Anthony Lombardo
• Alexandra Danielle Long, APN
• Daniel Philip Longo, D.C.
• Jennifer Longo, LCSW

• Student in an Organized Health Care Education/Training Program in Nutley, NJ
• Providers in Nutley, NJ by specialty
• Student in an Organized Health Care Education/Training Program in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.