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1659811974
MARTIN JUNIOR LAVILLE
NEW YORK, NY
NPI
1659811974
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NY 341519)
Enumeration Date
2017-03-06
Last Update Date
2021-02-05
Business Address
Mr. MARTIN JUNIOR LAVILLE M.S, RN, FNP
550 1ST AVE
NEW YORK, NY 10016-6402
Phone number: 212-746-9729
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Mailing Address
Mr. MARTIN JUNIOR LAVILLE M.S, RN, FNP
4054 CARPENTER AVE APT 3B
BRONX, NY 10466-3662
Phone number: 516-849-5111
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