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General NPI Number Information
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NPI Number | 1578841797
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Entity Type | Individual
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Provider Name | DANIEL SYLVAN LAVY M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/22/2011
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 350 SEYMOUR AVE STE 2
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City | DERBY
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State | CT
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Zip | 06418-1336
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Country | US
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Telephone | 203-732-3443
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Fax | 855-287-1988
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Provider Business Mailing Address
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Address Line | 67 MAPLE AVE
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City | DERBY
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State | CT
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Zip | 06418-1328
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 61826
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 61826
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License Number State | CT
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