Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jake Michael Licciardi, RN

Individual provider Registered Nurse · NPI 1861316309

Jake Michael Licciardi, RN is a Registered Nurse in Manorville, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2026
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

18 Sandie Ln
Manorville, NY 11949-2849
Phone: (631) 655-9864
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence N46557 (NY)

Record details

NPI number1861316309
Entity typeIndividual (Type 1)
GenderMale
Credentials RN
Sole proprietorYes
NPI enumeratedAugust 6, 2026
Last updated in NPPESAugust 6, 2026
Certification dateAugust 6, 2026
Mailing address18 Sandie Ln, Manorville, NY 11949-2849

Other providers in Manorville