Individual
MR. ALAN R LAVENDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17230
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
494299
TUFTS
MA
01
—
613720
HARVARD PILGRIM HLTH CARE
—
01
—
6400217
UNITED HEALTHCARE
—
01
—
817690
AETNA
—
01
—
P00289050
RR MEDICARE
—
01
—
Y68462
BLUE CROSS BLUE SHIELD
MA
Enumeration date
09/15/2006
Last updated
07/08/2007
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