Provider Demographics
NPI:1326608779
Name:LAVERGNE, PASCAL (MD)
Entity Type:Individual
Prefix:
First Name:PASCAL
Middle Name:
Last Name:LAVERGNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:983 BOULEVARD RAYMOND
Mailing Address - Street 2:
Mailing Address - City:QUEBEC
Mailing Address - State:QC
Mailing Address - Zip Code:G1B1J6
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 11TH ST, THOMAS JEFFERSON UNIVERSITY
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107
Practice Address - Country:US
Practice Address - Phone:215-955-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD466286207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery