Provider Demographics
NPI:1295784098
Name:LAZZARI, ANTONIO AUGUSTO (MD)
Entity type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:AUGUSTO
Last Name:LAZZARI
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:150 S HUNTINGTON AVE
Mailing Address - Street 2:SUITE F 2-10
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4817
Mailing Address - Country:US
Mailing Address - Phone:857-364-4418
Mailing Address - Fax:857-364-6547
Practice Address - Street 1:150 S HUNTINGTON AVE
Practice Address - Street 2:SUITE F 2-29
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130-4817
Practice Address - Country:US
Practice Address - Phone:857-364-4418
Practice Address - Fax:857-364-6547
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2015-10-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA72328207R00000X, 207RR0500X, 2085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging