Provider Demographics
NPI:1659632123
Name:LAVINIO, FRANK M (RPH)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:M
Last Name:LAVINIO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-3041
Mailing Address - Country:US
Mailing Address - Phone:201-659-4992
Mailing Address - Fax:201-659-4971
Practice Address - Street 1:900 WILLOW AVE
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-3041
Practice Address - Country:US
Practice Address - Phone:201-659-4992
Practice Address - Fax:201-659-4971
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01886100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI01886100OtherPHARMACY LICENSE