Provider Demographics
NPI:1346043205
Name:MCCLURG, LAVET LORENZ
Entity type:Individual
Prefix:
First Name:LAVET
Middle Name:LORENZ
Last Name:MCCLURG
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:LOVETTE
Other - Middle Name:LORENZ
Other - Last Name:MCCLURG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:719 HARRISON ST FL 3
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2695
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:719 HARRISON ST FL 3
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2695
Practice Address - Country:US
Practice Address - Phone:315-464-3117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program