Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0402X | Child Neurologist | MA71366 | NJ |
N | 2084N0600X | Clinical Neurophysiologist | MA71366 | NJ |
NPI | 1043305204 |
---|---|
Provider Name | Dr. Lorraine M. Lazar |
First Address | Mendham, NJ 07945-2146 |
Second Address | Morristown, NJ 07960-6136 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8304505 | (05) | NJ |
H25876 | (02) |