Provider Demographics
NPI:1851164487
Name:LAZAR, GARY P
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:P
Last Name:LAZAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5538 RAWHIDE DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-4344
Mailing Address - Country:US
Mailing Address - Phone:845-461-1530
Mailing Address - Fax:
Practice Address - Street 1:5538 RAWHIDE DR
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-4344
Practice Address - Country:US
Practice Address - Phone:845-461-1530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)