Provider Demographics
NPI:1053510479
Name:LAZARIN, GABRIEL (MS)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:LAZARIN
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5605 W EUGIE AVE STE 212
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-1275
Mailing Address - Country:US
Mailing Address - Phone:480-551-9700
Mailing Address - Fax:
Practice Address - Street 1:5605 W EUGIE AVE STE 212
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304-1275
Practice Address - Country:US
Practice Address - Phone:480-551-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS