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1902564800 NPI number — DANIEL WALTER LAVIN

NPI Number: 1902564800
Health Care Provider/Practitioner: DANIEL WALTER LAVIN

Information about “1902564800” NPI (DANIEL WALTER LAVIN) exists in 1902564800 in HTML format HTML  |  1902564800 in plain Text format TXT  |  1902564800 in PDF (Portable Document Format) PDF  |  1902564800 in an XML format XML  formats.

NPI Number : 1902564800 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1902564800",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LAVIN",
    "FirstName": "DANIEL",
    "MiddleName": "WALTER",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "85 EDGEBROOK RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FRAMINGHAM",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "01701-3813",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "508-788-5567",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "31 DOG RIVER DRIVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NORTHFIELD",
    "PracticeLocationAddressStateName": "VT",
    "PracticeLocationAddressPostalCode": "05663",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "802-485-8550",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/08/2021",
    "LastUpdateDate": "12/08/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "146N00000X",
        "TaxonomyName": "Basic Emergency Medical Technician",
        "LicenseNumber": "105501",
        "LicenseNumberStateCode": "VT",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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