Individual provider · Type 1 NPI
Jake Michael Licciardi, RN
Registered Nurse · Manorville, NY
Practice location
18 Sandie Ln
Manorville, NY 11949-2849
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse Primary | 163W00000X | N46557 (NY) |
Registered Nurse: (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient…
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About NPI 1861316309
Jake Michael Licciardi, RN's National Provider Identifier is 1861316309, issued on Aug 6, 2026. The primary taxonomy on file is Registered Nurse (163W00000X), and the practice location is in Manorville, NY. The record was last updated on Aug 6, 2026.