Provider Demographics
NPI:1952415747
Name:LAVIGNE, JOANNE B (NP)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:B
Last Name:LAVIGNE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:321 GIFFORD ST
Mailing Address - Street 2:PEDIATRICS
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-3201
Mailing Address - Country:US
Mailing Address - Phone:315-703-2600
Mailing Address - Fax:315-703-2621
Practice Address - Street 1:321 GIFFORD ST
Practice Address - Street 2:PEDIATRICS
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-3201
Practice Address - Country:US
Practice Address - Phone:315-703-2600
Practice Address - Fax:315-703-2621
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2015-02-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF-380747363LP0200X
NY282073163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics