Individual
MARISSA LAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
95 ARMORY RD, STRATFORD, CT 06614-1753
(203) 384-3388
(203) 384-4034
Mailing address
C/O NORTHEAST MEDICAL GROUP, INC., 226 MILL HILL AVE., 3RD FLOOR, BRIDGEPORT, CT 06610-2826
(203) 384-3388
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6635
CT
Other
Enumeration date
08/08/2016
Last updated
01/11/2017
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