Dr. Lisa Marie Gudicello, M.D.
Ophthalmology in Ridgewood, NJ. Individual provider (NPI-1).
NPI number1386794576
StatusActive
Last updated in NPPESJan 26, 2023
Details
- NPI
- 1386794576
- Entity type
- Individual (NPI-1)
- Name
- Dr. Lisa Marie Gudicello
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 11, 2007
- Certification date
- Jan 26, 2023
- Last updated
- Jan 26, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - OPHTHALMOLOGY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207W00000X | Ophthalmology | 318455 | NY | Yes |
| 207W00000X | Ophthalmology | Ma06926700 | NJ |
Practice location
440 Northern PkwyRidgewood, NJ 07450-1721
Phone 201-220-2654 · Fax 201-220-2654
Mailing address
440 Northern PkwyRidgewood, NJ 07450-1721
Phone 201-220-2654 · Fax 201-220-2654
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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