Provider Demographics
NPI:1609872738
Name:LAZAROU, ZOE K (OD)
Entity Type:Individual
Prefix:DR
First Name:ZOE
Middle Name:K
Last Name:LAZAROU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 LORD BALTIMORE DR.
Mailing Address - Street 2:STE 300
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2568
Mailing Address - Country:US
Mailing Address - Phone:410-277-3937
Mailing Address - Fax:410-281-9388
Practice Address - Street 1:2925 LORD BALTIMORE DR.
Practice Address - Street 2:STE 300
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-2568
Practice Address - Country:US
Practice Address - Phone:410-277-3937
Practice Address - Fax:410-281-9388
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1633152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD689101200Medicaid
MDK769B691Medicare PIN
MDU77503Medicare UPIN