Pesavento, Lara Jane
Pesavento, Lara Jane is an individual health care provider with primary practice located at 1701 N Senate Blvd , Indianapolis IN 46202-1239. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Pesavento, Lara Jane can be contacted via phone (317) 567-2180.Contact Information
Primary practice address
1701 N Senate Blvd
Indianapolis IN 46202-1239
Phone: (317) 567-2180
Fax: (317) 614-9655
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 01061430 | Indiana |
Profile Details
| NPI number | 1073501235 |
|---|---|
| LBN Legal business name | Pesavento, Lara Jane |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 12th, 2005 |
| Last updated | Jul 19th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073501235 | NPPES |
| Indiana | MEDICAID | 200849010 |
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