Provider Demographics
NPI:1033292289
Name:LAZAROW, NORMAND HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAND
Middle Name:HENRY
Last Name:LAZAROW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 HARBOR HILL RD
Mailing Address - Street 2:
Mailing Address - City:WOODS HOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02543-1215
Mailing Address - Country:US
Mailing Address - Phone:508-548-5860
Mailing Address - Fax:508-548-5860
Practice Address - Street 1:16 HARBOR HILL RD
Practice Address - Street 2:
Practice Address - City:WOODS HOLE
Practice Address - State:MA
Practice Address - Zip Code:02543-1215
Practice Address - Country:US
Practice Address - Phone:508-548-5860
Practice Address - Fax:508-548-5860
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233628207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND23768OtherBLUECROSSBLUESHIELDNODAK
ND12853Medicaid
NDN23768Medicare ID - Type Unspecified
ND12853Medicaid