Provider Demographics
NPI:1033723119
Name:LAZOL, LOUISE MARGARRETTE (RN)
Entity Type:Individual
Prefix:
First Name:LOUISE MARGARRETTE
Middle Name:
Last Name:LAZOL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LOUISE
Other - Middle Name:
Other - Last Name:LAZOL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:362 PARKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1480
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:362 PARKSIDE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-1480
Practice Address - Country:US
Practice Address - Phone:209-202-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY780637-01163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical