Provider Demographics
NPI:1093898843
Name:LAVANGO, VITO F (RPH)
Entity Type:Individual
Prefix:MR
First Name:VITO
Middle Name:F
Last Name:LAVANGO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:VITO
Other - Middle Name:F
Other - Last Name:LAVANGO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:2341 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3024
Mailing Address - Country:US
Mailing Address - Phone:585-217-7716
Mailing Address - Fax:
Practice Address - Street 1:2341 MONROE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3024
Practice Address - Country:US
Practice Address - Phone:585-217-7716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2011-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042910183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist