Active NPI
Rebecca Lazerson, DNP, APN, ACCNS-P
- Pediatric Clinical Nurse Specialist
- Philadelphia, PA
National Provider Identifier
1679493324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Clinical Nurse Specialist
- License
- CNS000411
- Practice address
- 3401 Civic Center Boulevard
Philadelphia, PA 19104 - Phone
- (445) 326-8076
- NPI assigned
- Jul 21, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | 26NJ15492100 | NJ | |
| Pediatric Clinical Nurse Specialist | 364SP0200X | CNS000411 | PA | Primary |
Addresses
Primary practice location
3401 Civic Center Boulevard
Philadelphia, PA 19104
Mailing address
47 Bryant Rd
Blackwood, NJ 08012-1445
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1784592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787011200000",
"number": "1679493324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 BRYANT RD",
"city": "BLACKWOOD",
"state": "NJ",
"postal_code": "080121445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BOULEVARD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "445-326-8076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAZERSON",
"first_name": "REBECCA",
"credential": "DNP, APN, ACCNS-P",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-07-21",
"last_updated": "2026-08-18",
"certification_date": "2026-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "NJ",
"license": "26NJ15492100",
"primary": false
},
{
"code": "364SP0200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Pediatrics",
"state": "PA",
"license": "CNS000411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.