Provider Demographics
NPI:1942964572
Name:LAZARE, ABBIE
Entity Type:Individual
Prefix:
First Name:ABBIE
Middle Name:
Last Name:LAZARE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1322
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-0316
Mailing Address - Country:US
Mailing Address - Phone:518-858-3192
Mailing Address - Fax:
Practice Address - Street 1:4 JEFFERSON PLZ
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-4035
Practice Address - Country:US
Practice Address - Phone:845-473-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY491662-01163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health