Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 959 | CT |
Y | 222Z00000X | Podiatrist | 959 | CT |
N | 111NR0200X | Radiology | 959 | CT |
N | 213ER0200X | Radiology | 959 | CT |
N | 213ES0131X | Foot Surgery | 959 | CT |
N | 213E00000X | Podiatrist | 959 | CT |
N | 222Z00000X | Podiatrist | 959 | CT |
N | 225000000X | Orthotic Fitter | 959 |
NPI | 1588084362 |
---|---|
Provider Name | Stephen Lazaroff |
First Address | North Haven, CT 06473-4337 |
Second Address | Waterbury, CT 06708-3012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2014 |
Last Update Date | 17/03/2018 |