Individual
ALEXIS LAFAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6054 CAVANAUGH RD, MARCY, NY 13403
(315) 737-3439
Mailing address
PO BOX 160, PROSPECT, NY 13435
(315) 737-3439
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
336888-01
NY
Other
Enumeration date
02/10/2020
Last updated
02/10/2020
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