Provider Demographics
NPI:1891925764
Name:BAZZI, LAMA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAMA
Middle Name:
Last Name:BAZZI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 NESCONSET HWY
Mailing Address - Street 2:STONY BROOK MEDICAL PARK BLDG 2
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-2555
Mailing Address - Country:US
Mailing Address - Phone:631-444-2769
Mailing Address - Fax:
Practice Address - Street 1:2500 NESCONSET HIGHWAY BLDG 2
Practice Address - Street 2:STONY BROOK FACULTY PRACTICE
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-2551
Practice Address - Country:US
Practice Address - Phone:631-444-2769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2756362084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry