Jake Michael Licciardi, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

N46557 Issued in NY

Practice address

18 Sandie LN
Manorville, NY 11949-2849

Phone

(631) 655-9864

NPI assigned

Aug 6, 2026

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1785974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1861316309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 SANDIE LN",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 SANDIE LN",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119492849",
            "telephone_number": "631-655-9864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICCIARDI",
        "first_name": "JAKE",
        "middle_name": "MICHAEL",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-08-06",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "N46557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Jin Lee, DPT
• Richard A Lefebvre Jr.
• Jaime Christine Legault
• Karen Ann Leonardis
• Darian Licata, OTR/L
• Faith Veronica Lidonnici, PT
• Diana Lindquist, O.T.R.
• Sandie Linger-Mines
• Danielle Lipira, RN
• Lisa Perrino Inc

• Registered Nurse in Manorville, NY
• Providers in Manorville, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.

Verify at the official NPI Registry.