Provider Demographics
NPI:1538712732
Name:LAVIN, CRAIG ALAN (DNP, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ALAN
Last Name:LAVIN
Suffix:
Gender:M
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:392 CENTRAL PARK W APT 9J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5817
Mailing Address - Country:US
Mailing Address - Phone:646-668-7721
Mailing Address - Fax:
Practice Address - Street 1:2581 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-2412
Practice Address - Country:US
Practice Address - Phone:646-668-7721
Practice Address - Fax:718-345-5468
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY729883163W00000X
NY402851363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse