| Doctor Name: | JEAN MARIE LAVIN |
| NPI Number: | 1134311707 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | 501189-1 |
| Business Practice Address: | 12 Chalmers Blvd Amawalk, NY - 105011217 |
| Business Phone Number: | 9145943131 |
| Business Fax Number: | 9145944513 |
| Mailing Address: | 12 Chalmers Blvd, AMAWALK |
| State: | NY |
| Postal Code: | 105011217 |
| Phone Number: | 9145943131 |
| Fax Number: | 9145944513 |
| NPI Enumeration Date: | 08/16/2007 |
| NPI Last Update Date: | 08/16/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0200X |
| License Number: | 501189-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |