Provider Demographics
NPI:1043399355
Name:LAVIN, MARIBETH ANNE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:MARIBETH
Middle Name:ANNE
Last Name:LAVIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10710 SHORE FRONT PKWY
Mailing Address - Street 2:APT.8F
Mailing Address - City:ROCKAWAY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11694-2637
Mailing Address - Country:US
Mailing Address - Phone:718-634-1878
Mailing Address - Fax:718-289-2274
Practice Address - Street 1:27111 76TH AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1436
Practice Address - Country:US
Practice Address - Phone:718-289-2272
Practice Address - Fax:718-289-2274
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0466461835G0303X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1835G0303XPharmacy Service ProvidersPharmacistGeriatric
Not Answered183500000XPharmacy Service ProvidersPharmacist