Individual
HARRISON JOSEPH LAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
133 E MERRICK RD, VALLEY STREAM, NY 11580-5900
(516) 887-5500
Mailing address
16 BLACKSMITH RD, LEVITTOWN, NY 11756-3106
(828) 289-2012
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
025067
NY
Other
Enumeration date
06/26/2020
Last updated
06/26/2020
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