Individual
GREGORY LLOYD LAVIGNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
315 S MANNING BLVD, 3-CUSACK RM 3503, ALBANY, NY 12208-1707
(518) 525-1304
(518) 525-6496
Mailing address
315 S MANNING BLVD, 3-CUSACK RM 3503, ALBANY, NY 12208-1707
(518) 525-1304
(518) 525-6496
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
145331-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0080854-99
GHI
NY
05
—
01699352
—
NY
01
—
10001142
CDPHP
NY
01
—
64E081
BLUE CROSS
NY
01
—
91244
MVP
NY
Enumeration date
10/18/2006
Last updated
07/08/2007
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