| NPI | 1235588997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD J LAVOIE Sole Propietor 860-887-1316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2016-06-03 |