Provider Demographics
NPI:1073892121
Name:LAVOOY, SARINA (DPT)
Entity Type:Individual
Prefix:
First Name:SARINA
Middle Name:
Last Name:LAVOOY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CLIFFSIDE TER
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:NJ
Mailing Address - Zip Code:07461-4807
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:212 ROUTE 94
Practice Address - Street 2:STE 2F
Practice Address - City:VERNON
Practice Address - State:NJ
Practice Address - Zip Code:07462-3328
Practice Address - Country:US
Practice Address - Phone:973-209-0086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01406800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist