Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | 274648 | NY |
Y | 2086S0105X | Surgery of the Hand | MD451052 | PA |
NPI | 1720278302 |
---|---|
Provider Name | Dr. Dana Lavanture |
First Address | Sayre, PA 18840-1625 |
Second Address | Sayre, PA 18840-1625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2007 |
Last Update Date | 03/03/2021 |