Provider Demographics
NPI:1467686535
Name:LAZAR, SHARON R (OTR)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:R
Last Name:LAZAR
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:SURI
Other - Middle Name:R
Other - Last Name:LAMM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:555 OAK DR
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5410
Mailing Address - Country:US
Mailing Address - Phone:718-471-6401
Mailing Address - Fax:
Practice Address - Street 1:555 OAK DR
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5410
Practice Address - Country:US
Practice Address - Phone:718-471-6401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004662225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics