Basic Information
| Provider Information | |||||||||
| NPI: | 1316188691 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KATHLEEN A. LAVORGNA, MD, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 40 CROSS ST | ||||||||
| Address2: | |||||||||
| City: | NORWALK | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068514647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2038463338 | ||||||||
| FaxNumber: | 2038466010 | ||||||||
| Practice Location | |||||||||
| Address1: | 40 CROSS ST | ||||||||
| Address2: | |||||||||
| City: | NORWALK | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068514647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2038463338 | ||||||||
| FaxNumber: | 2038466010 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2009 | ||||||||
| LastUpdateDate: | 03/16/2009 | ||||||||
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| AuthorizedOfficialLastName: | LAVORGNA | ||||||||
| AuthorizedOfficialFirstName: | KATHLEEN | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2038463338 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 029808 | CT | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.