Provider Demographics
NPI:1578303509
Name:LAVIGNE, ALEXANDRE
Entity type:Individual
Prefix:MR
First Name:ALEXANDRE
Middle Name:
Last Name:LAVIGNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700, RUE GARNIER, APT 111 MONTREAL QC CANADA
Mailing Address - Street 2:
Mailing Address - City:MONTREAL
Mailing Address - State:QC
Mailing Address - Zip Code:H2G 0A1
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6300, AVE DE DARLINGTON
Practice Address - Street 2:
Practice Address - City:MORTREAL
Practice Address - State:QC
Practice Address - Zip Code:H3S 2J4
Practice Address - Country:CA
Practice Address - Phone:514-340-2083
Practice Address - Fax:514-340-2775
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-28
Last Update Date:2025-01-16
Deactivation Date:2025-01-14
Deactivation Code:
Reactivation Date:2025-01-16
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program