Provider Demographics
NPI:1336736404
Name:LESSING, KAREN REVA (RN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:REVA
Last Name:LESSING
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 1:249 BROAD ST APT 417
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3265
Mailing Address - Country:US
Mailing Address - Phone:908-600-9939
Mailing Address - Fax:
Practice Address - Street 1:249 BROAD ST APT 417
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3265
Practice Address - Country:US
Practice Address - Phone:908-600-9939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR06725600163WS0121X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NR06725600OtherNURSING