Provider Demographics
NPI:1912939638
Name:LAVIGNE, DONALD J (DC)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:J
Last Name:LAVIGNE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MORRISTOWN RD
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:BERNARDSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07924-2310
Mailing Address - Country:US
Mailing Address - Phone:908-766-5663
Mailing Address - Fax:908-766-7768
Practice Address - Street 1:40 MORRISTOWN RD
Practice Address - Street 2:SUITE 1B
Practice Address - City:BERNARDSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07924-2310
Practice Address - Country:US
Practice Address - Phone:908-766-5663
Practice Address - Fax:908-766-7768
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC 04886111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU67746Medicare UPIN
NJ001497RFDMedicare PIN