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Individual

DR. SEAN DAVID LAVINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
710 W 168TH ST, NI-424, NEW YORK, NY 10032-3726
(212) 305-0135
(212) 305-3629
Mailing address
710 W 168TH ST, NI-424, NEW YORK, NY 10032-3726
(212) 305-0135
(212) 305-3629

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
223585
NY
2085R0204X
Vascular & Interventional Radiology Physician
223585
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02255365
NY
Enumeration date
01/19/2007
Last updated
11/08/2022
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