Provider Demographics
NPI:1962293407
Name:LIVECCHI, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:LIVECCHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106-2017
Mailing Address - Country:US
Mailing Address - Phone:609-707-0677
Mailing Address - Fax:
Practice Address - Street 1:111 HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-2017
Practice Address - Country:US
Practice Address - Phone:609-707-0677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR26935300163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse