Provider Demographics
NPI:1689064628
Name:LAZIO, PATRICIA (RN, NP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:LAZIO
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 E 90TH ST
Mailing Address - Street 2:APT 2B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0671
Mailing Address - Country:US
Mailing Address - Phone:212-427-1590
Mailing Address - Fax:
Practice Address - Street 1:14 E 90TH ST
Practice Address - Street 2:APT 2B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0671
Practice Address - Country:US
Practice Address - Phone:212-427-1590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY351022-1163WG0000X
NYF330255-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily