NPI Code Detail JSON Logo

1275975161 NPI number — LISA DIANE IUCCI DO

NPI Number: 1275975161
Health Care Provider/Practitioner: LISA DIANE IUCCI DO

Information about “1275975161” NPI (LISA DIANE IUCCI DO) exists in 1275975161 in HTML format HTML  |  1275975161 in plain Text format TXT  |  1275975161 in PDF (Portable Document Format) PDF  |  1275975161 in an XML format XML  formats.

NPI Number : 1275975161 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1275975161",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "IUCCI",
    "FirstName": "LISA",
    "MiddleName": "DIANE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DO",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HARASYMCZUK",
    "OtherFirstName": "LISA",
    "OtherMiddleName": "DIANE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "DO",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "200 SCHULZ DR STE 2",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RED BANK",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "07701-6745",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "327-426-3420",
    "MailingAddressFaxNumber": "732-747-2606",
    "FirstLinePracticeLocationAddress": "4096 ENGLISH CREEK AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "EGG HARBOR TOWNSHIP",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "08234-5746",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "609-204-5357",
    "PracticeLocationAddressFaxNumber": "609-272-7755",
    "EnumerationDate": "07/22/2013",
    "LastUpdateDate": "04/18/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "208600000X",
        "TaxonomyName": "Surgery Physician",
        "LicenseNumber": "25MB10400100",
        "LicenseNumberStateCode": "NJ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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