Provider Demographics
NPI:1063485175
Name:LAZAR, JEFFREY CARL (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:CARL
Last Name:LAZAR
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-2465
Mailing Address - Fax:717-741-3043
Practice Address - Street 1:2350 FREEDOM WAY
Practice Address - Street 2:SUITE 202
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-8200
Practice Address - Country:US
Practice Address - Phone:717-851-2465
Practice Address - Fax:717-741-3043
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD040131L207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1035600OtherGATEWAY
MD965273OtherCAREFIRST MD BCBS
PA299690OtherUNISON-WMG
PA555721OtherHIGHMARK BLUE SHIELD-WMG
PA1035600OtherGATEWAY-WMG
PA0011537200002Medicaid
PA200065OtherUPMC-WMG
PA30073070OtherAMERIHEALTH MERCY-WMG
PA30073070OtherAMERIHEALTH MERCY-WMG
PA555721OtherHIGHMARK BLUE SHIELD-WMG