Provider Demographics
NPI:1376298257
Name:BEARFIELD, LAVONIA
Entity Type:Individual
Prefix:MS
First Name:LAVONIA
Middle Name:
Last Name:BEARFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-2836
Mailing Address - Country:US
Mailing Address - Phone:862-206-4072
Mailing Address - Fax:862-367-8202
Practice Address - Street 1:177 VALLEY ST
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-2836
Practice Address - Country:US
Practice Address - Phone:862-206-4072
Practice Address - Fax:862-367-8202
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty