Provider Demographics
NPI:1932232154
Name:LAZAR, STEVEN SAUL (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:SAUL
Last Name:LAZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 WEST END AVE.
Mailing Address - Street 2:10B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:212-496-7799
Mailing Address - Fax:
Practice Address - Street 1:1518 43RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-1605
Practice Address - Country:US
Practice Address - Phone:718-436-9111
Practice Address - Fax:718-436-5460
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131273207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB77649Medicare UPIN