Basic Information
| Provider Information | |||||||||
| NPI: | 1578841797 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAVY | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | SYLVAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2200 WHITNEY AVE STE 170 | ||||||||
| Address2: | |||||||||
| City: | HAMDEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065183694 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032817000 | ||||||||
| FaxNumber: | 2039096782 | ||||||||
| Practice Location | |||||||||
| Address1: | 2200 WHITNEY AVE STE 170 | ||||||||
| Address2: | |||||||||
| City: | HAMDEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065183694 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032817000 | ||||||||
| FaxNumber: | 2039096782 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2011 | ||||||||
| LastUpdateDate: | 05/27/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 61826 | CT | N | Allopathic & Osteopathic Physicians | Surgery | 208C00000X | 61826 | CT | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery |
No ID Information.