Provider Demographics
NPI:1063265908
Name:GOVINDASAMY, LAVANYA
Entity type:Individual
Prefix:DR
First Name:LAVANYA
Middle Name:
Last Name:GOVINDASAMY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14131 TRAVIS ST APT 801
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-4808
Mailing Address - Country:US
Mailing Address - Phone:408-909-2331
Mailing Address - Fax:
Practice Address - Street 1:EAST VIRGINIA MEDICAL SCHOOL, EVMS PEDIATRICS
Practice Address - Street 2:601, CHILDREN'S LANE
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-9982
Practice Address - Country:US
Practice Address - Phone:757-668-7249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program