Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD429330 | PA |
N | 2080P0204X | Pediatric Emergency Doctor | MD429330 | PA |
NPI | 1306054374 |
---|---|
Provider Name | Megan Lavoie |
First Address | Philadelphia, PA 19103-1454 |
Second Address | Philadelphia, PA 19104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 08/07/2007 |