Provider Demographics
NPI:1962822585
Name:LAVOIE, REJANE (MD)
Entity Type:Individual
Prefix:DR
First Name:REJANE
Middle Name:
Last Name:LAVOIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:REJANE
Other - Middle Name:
Other - Last Name:LAVOIE-AGRAWALA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10903 W LAURELWOOD LN
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-4033
Mailing Address - Country:US
Mailing Address - Phone:623-877-9141
Mailing Address - Fax:
Practice Address - Street 1:10903 W LAURELWOOD LN
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-4033
Practice Address - Country:US
Practice Address - Phone:623-877-9141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-22
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20937208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics