1578303509 NPI number — MR. ALEXANDRE LAVIGNE

Table of content: MR. ALEXANDRE LAVIGNE (NPI 1578303509)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578303509 NPI number — MR. ALEXANDRE LAVIGNE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAVIGNE
Provider First Name:
ALEXANDRE
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578303509
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/16/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
01/14/2025
NPI Reactivation Date:
01/16/2025

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5700, RUE GARNIER, APT 111 MONTREAL QC CANADA
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONTREAL
Provider Business Mailing Address State Name:
QC
Provider Business Mailing Address Postal Code:
H2G 0A1
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6300, AVE DE DARLINGTON
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORTREAL
Provider Business Practice Location Address State Name:
QC
Provider Business Practice Location Address Postal Code:
H3S 2J4
Provider Business Practice Location Address Country Code:
CA
Provider Business Practice Location Address Telephone Number:
514-340-2083
Provider Business Practice Location Address Fax Number:
514-340-2775
Provider Enumeration Date:
05/28/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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