Individual
ZACHARY RICHARD LAVENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
80 SEYMOUR ST, HH MEDICINE DEPARTMENT, HARTFORD, CT 06102-8000
(860) 545-5000
Mailing address
80 SEYMOUR ST, HH MEDICINE DEPARTMENT, HARTFORD, CT 06102-8000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
003689
CT
363AM0700X
Medical Physician Assistant
Primary
003689
CT
Other
Enumeration date
08/02/2016
Last updated
10/31/2016
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