Gina M Lisberger, R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

630514-1 Issued in NY

Practice address

3251 Route 112
BLDG. 9/Suite 2
Medford, NY 11763-1446

Phone

(631) 451-6007

Fax

(631) 297-8121

NPI assigned

Dec 30, 2011

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

Other names 1

• Gina M Cinquemani Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1325203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1871863324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SEAFIELD LN",
            "city": "WESTHAMPTON BEACH",
            "state": "NY",
            "postal_code": "119782714",
            "telephone_number": "631-288-1113",
            "fax_number": "631-730-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 ROUTE 112",
            "address_2": "BLDG. 9/SUITE 2",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631446",
            "telephone_number": "631-451-6007",
            "fax_number": "631-297-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISBERGER",
        "first_name": "GINA",
        "middle_name": "M",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-30",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "630514",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "630514-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "CINQUEMANI",
            "middle_name": "M",
            "credential": "R.N.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Nurse in Medford, NY
• Providers in Medford, 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 Apr 10, 2019; 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.