Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 25MB027478 | NJ |
NPI | 1013049758 |
---|---|
Provider Name | Dr. Lawrence Joseph Zazzo |
First Address | Marlton, NJ 08053-2072 |
Second Address | Camden, NJ 08103-3529 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2007 |
Last Update Date | 08/07/2007 |