Provider Demographics
NPI:1760437065
Name:LAZARUS, LAURI (PT)
Entity Type:Individual
Prefix:MS
First Name:LAURI
Middle Name:
Last Name:LAZARUS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8429 N 80TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-2211
Mailing Address - Country:US
Mailing Address - Phone:602-677-7788
Mailing Address - Fax:602-997-8020
Practice Address - Street 1:6245 N 24TH PKWY
Practice Address - Street 2:SUITE 105
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-2024
Practice Address - Country:US
Practice Address - Phone:602-997-7844
Practice Address - Fax:602-997-8020
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0485225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ61104Medicare ID - Type Unspecified