Provider Demographics
NPI:1609468511
Name:BUFFINGTON, LAVENA RUDI
Entity Type:Individual
Prefix:
First Name:LAVENA
Middle Name:RUDI
Last Name:BUFFINGTON
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 1:4456 SEXTON RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-6005
Mailing Address - Country:US
Mailing Address - Phone:216-314-7964
Mailing Address - Fax:
Practice Address - Street 1:4456 SEXTON RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-6005
Practice Address - Country:US
Practice Address - Phone:216-314-7964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator