Provider Demographics
NPI:1194206508
Name:LAVINIO, CHRISTINE (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:LAVINIO
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:LAVINIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:105 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-2430
Mailing Address - Country:US
Mailing Address - Phone:516-488-1115
Mailing Address - Fax:
Practice Address - Street 1:900 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-2145
Practice Address - Country:US
Practice Address - Phone:516-256-6090
Practice Address - Fax:516-256-6092
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041763-13336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy