Provider Demographics
NPI:1295874816
Name:LAVY, RICHARD CECIL (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:CECIL
Last Name:LAVY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:300 WILLOW VALLEY LAKES DR
Mailing Address - Street 2:APT. C-124
Mailing Address - City:WILLOW STREET
Mailing Address - State:PA
Mailing Address - Zip Code:17584-9442
Mailing Address - Country:US
Mailing Address - Phone:717-464-4876
Mailing Address - Fax:
Practice Address - Street 1:4201 PATTERSON AVE
Practice Address - Street 2:MARYLAND PROFESSIONAL VOLUNTEER CORPS
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-2222
Practice Address - Country:US
Practice Address - Phone:717-464-4876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2012-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0007766207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology