Provider Demographics
NPI:1073747580
Name:SPITALETTO, LIZA MARI (RN)
Entity Type:Individual
Prefix:
First Name:LIZA MARI
Middle Name:
Last Name:SPITALETTO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S LIVINGSTON AVE
Mailing Address - Street 2:SUITE 2G
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4043
Mailing Address - Country:US
Mailing Address - Phone:973-716-9716
Mailing Address - Fax:
Practice Address - Street 1:201 S LIVINGSTON AVE
Practice Address - Street 2:SUITE 2G
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4043
Practice Address - Country:US
Practice Address - Phone:973-716-9716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO12429100163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant