Provider Demographics
NPI:1295068476
Name:TAYLOR, LANVIN F II (DO)
Entity type:Individual
Prefix:DR
First Name:LANVIN
Middle Name:F
Last Name:TAYLOR
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 E LAUREL RD STE 1700
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084-1354
Mailing Address - Country:US
Mailing Address - Phone:856-566-7010
Mailing Address - Fax:856-566-6956
Practice Address - Street 1:42 E LAUREL RD STE 1700
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1354
Practice Address - Country:US
Practice Address - Phone:856-566-7010
Practice Address - Fax:856-566-6956
Is Sole Proprietor?:No
Enumeration Date:2009-09-07
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB10795000208100000X
PAOS016300208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1E4349OtherMEDICARE PIN