Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 039499-1 | NY |
Y | 213EG0000X | General Practice | 039499-1 | NY |
NPI | 1003838426 |
---|---|
Provider Name | Dr. John Paul Lazarus |
First Address | Clarence Center, NY 14032-9142 |
Second Address | Buffalo, NY 14215-1129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 08/07/2007 |