Provider Demographics
NPI:1114972296
Name:REGAN-LIVINGSTON, JANET LYNN (NP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LYNN
Last Name:REGAN-LIVINGSTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 SCHRAALENBURGH RD
Mailing Address - Street 2:
Mailing Address - City:HAWORTH
Mailing Address - State:NJ
Mailing Address - Zip Code:07641-1813
Mailing Address - Country:US
Mailing Address - Phone:201-403-1910
Mailing Address - Fax:
Practice Address - Street 1:250 OLD HOOK RD
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3123
Practice Address - Country:US
Practice Address - Phone:201-781-1300
Practice Address - Fax:201-383-1983
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN09179900363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9096809Medicaid
NJ035955Medicare ID - Type Unspecified
NJ9096809Medicaid