Healthcare Provider Details

I. General information

NPI: 1205938909
Provider Name (Legal Business Name): MAUREEN S LAVOIE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. MAUREEN SCARPATO

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 SUMMER ST
WORCESTER MA
01608-1216
US

IV. Provider business mailing address

462 CENTRAL ST
BOYLSTON MA
01505-1524
US

V. Phone/Fax

Practice location:
  • Phone: 508-363-5000
  • Fax:
Mailing address:
  • Phone: 774-614-1019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number265362
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: