Organization
M LAVIAN MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANOUCHEHR LAVIAN M.D. (OWNER)
(845) 341-1805
Entity
Organization
Contact information
Practice address
129 WICKHAM AVE, MIDDLETOWN, NY 10940-3714
(845) 341-1805
(845) 342-9218
Mailing address
129 WICKHAM AVE, MIDDLETOWN, NY 10940-3714
(845) 341-1805
(845) 342-9218
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
163228-1
NY
Other
Enumeration date
07/05/2012
Last updated
11/20/2012
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