Provider Demographics
NPI:1679846539
Name:STEPHEN LAZAROU MD
Entity Type:Organization
Organization Name:STEPHEN LAZAROU MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZAROU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-237-9000
Mailing Address - Street 1:1 WASHINGTON ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-1711
Mailing Address - Country:US
Mailing Address - Phone:781-237-9000
Mailing Address - Fax:781-237-9001
Practice Address - Street 1:1 WASHINGTON ST
Practice Address - Street 2:SUITE 206
Practice Address - City:WELLESLEY HILLS
Practice Address - State:MA
Practice Address - Zip Code:02481-1711
Practice Address - Country:US
Practice Address - Phone:781-237-9000
Practice Address - Fax:781-237-9001
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAZAROU UROLOGY ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA220000208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty