Provider Demographics
NPI:1740401926
Name:LAZARUS, CLIFFORD NEIL (PHD)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:NEIL
Last Name:LAZARUS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 BROOK DR E
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-9520
Mailing Address - Country:US
Mailing Address - Phone:609-497-7504
Mailing Address - Fax:
Practice Address - Street 1:98 TAMARACK CIR
Practice Address - Street 2:
Practice Address - City:SKILLMAN
Practice Address - State:NJ
Practice Address - Zip Code:08558-2020
Practice Address - Country:US
Practice Address - Phone:609-683-9122
Practice Address - Fax:609-683-5229
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00293800103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical