Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 249656 | NY |
N | 207XS0117X | Orthopaedic Spine Surgeon | 2496561 | NY |
NPI | 1134247646 |
---|---|
Provider Name | Dr. William F Lavelle |
First Address | East Syracuse, NY 13057 |
Second Address | East Syracuse, NY 13057 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 30/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03018619 | (05) | NY |