Lavinia May Couture, PA
Physician Assistant in Glen Ridge, NJ. Individual provider (NPI-1).
NPI number1255833281
StatusActive
Last updated in NPPESMay 16, 2018
Details
- NPI
- 1255833281
- Entity type
- Individual (NPI-1)
- Name
- Lavinia May Couture
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 6, 2018
- Last updated
- May 16, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
| 363AS0400X | Physician Assistant, Surgical | 25MP00466600 | NJ |
Practice location
230 Sherman AveGlen Ridge, NJ 07028
Phone 201-256-5317
Mailing address
404 Washington AveDumont, NJ 07628-1534
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