Provider Demographics
NPI:1437863925
Name:LAJARA, ANAIRIS
Entity Type:Individual
Prefix:
First Name:ANAIRIS
Middle Name:
Last Name:LAJARA
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 1:1652 MERIDEN RD APT 23
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06705-3922
Mailing Address - Country:US
Mailing Address - Phone:203-721-2881
Mailing Address - Fax:
Practice Address - Street 1:1652 MERIDEN RD APT 23
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06705-3922
Practice Address - Country:US
Practice Address - Phone:203-721-2881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT659359Medicaid