Provider Demographics
NPI:1205938909
Name:LAVOIE, MAUREEN S (NP)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:S
Last Name:LAVOIE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:MAUREEN
Other - Middle Name:
Other - Last Name:SCARPATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:462 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01505-1524
Mailing Address - Country:US
Mailing Address - Phone:774-614-1019
Mailing Address - Fax:
Practice Address - Street 1:123 SUMMER ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1216
Practice Address - Country:US
Practice Address - Phone:508-363-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA265362363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMA 265362OtherLICENSE