Provider Demographics
NPI:1346413754
Name:LAZZARA, ERINN
Entity Type:Individual
Prefix:MRS
First Name:ERINN
Middle Name:
Last Name:LAZZARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 556
Mailing Address - Street 2:
Mailing Address - City:MOUNT FREEDOM
Mailing Address - State:NJ
Mailing Address - Zip Code:07970-0556
Mailing Address - Country:US
Mailing Address - Phone:973-539-5624
Mailing Address - Fax:
Practice Address - Street 1:320 W. HANOVER AVE.
Practice Address - Street 2:
Practice Address - City:PARSIPANNY
Practice Address - State:NJ
Practice Address - Zip Code:07854
Practice Address - Country:US
Practice Address - Phone:973-539-5624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ101YA0400XMedicaid
NJ101A0400XMedicaid