Provider Demographics
NPI:1578981684
Name:NAVALLO, LAUREN JOYCE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:JOYCE
Last Name:NAVALLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 WATCHUNG AVE
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2700
Mailing Address - Country:US
Mailing Address - Phone:973-665-0900
Mailing Address - Fax:
Practice Address - Street 1:17 WATCHUNG AVE
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2700
Practice Address - Country:US
Practice Address - Phone:973-665-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-04
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10199500208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics