Lydia Ann Patrick-Deluca, MSN RN APN-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

26NJ00228000 Issued in NJ

Practice address

88 Porter PL
Montclair, NJ 07042-2036

Phone

(973) 865-4632

NPI assigned

Aug 13, 2009

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Registered Nurse

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

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250121600000",
    "number": "1508098302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 PORTER PL",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422036",
            "telephone_number": "973-865-4632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 PORTER PL",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422036",
            "telephone_number": "973-865-4632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK-DELUCA",
        "first_name": "LYDIA",
        "middle_name": "ANN",
        "credential": "MSN RN APN-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-13",
        "last_updated": "2009-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00228000",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ00228000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Path for Change Counseling, LLC
• Pathmark Stores Inc
• Patience Moore, LCSW, LLC
• Patient Centered Medical Associates, PA
• Patient Friendly Specialty Pharmacy -PFSP
• Regina Patrick
• Caitlyn Pawlek
• Lisa Pedi, M.S., CCC-SLP
• Joseph Peter Pedoto, PH.D.
• Brittany Peery, LCSW

• Primary Care Nurse Practitioner in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Primary Care Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2009; 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.