Provider Demographics
NPI:1497926620
Name:LAVIN, BRUCE SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:SCOTT
Last Name:LAVIN
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 1:3 JOHN TROUT RD
Mailing Address - Street 2:
Mailing Address - City:RINGOES
Mailing Address - State:NJ
Mailing Address - Zip Code:08551-2035
Mailing Address - Country:US
Mailing Address - Phone:908-782-4332
Mailing Address - Fax:908-782-3854
Practice Address - Street 1:3 JOHN TROUT RD
Practice Address - Street 2:
Practice Address - City:RINGOES
Practice Address - State:NJ
Practice Address - Zip Code:08551-2035
Practice Address - Country:US
Practice Address - Phone:908-782-4332
Practice Address - Fax:908-782-3854
Is Sole Proprietor?:No
Enumeration Date:2008-03-15
Last Update Date:2008-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG051174207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine