Provider Demographics
NPI:1417629247
Name:LAZORKA, CAITLYN (RDN)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:LAZORKA
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8915 EARLY APRIL WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2408
Mailing Address - Country:US
Mailing Address - Phone:443-381-2321
Mailing Address - Fax:
Practice Address - Street 1:11221 DOLFIELD BLVD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3254
Practice Address - Country:US
Practice Address - Phone:443-381-2321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered