Provider Demographics
NPI:1003084690
Name:LAZZARO EYE CENTER LLP
Entity type:Organization
Organization Name:LAZZARO EYE CENTER LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:LAZZARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-748-1334
Mailing Address - Street 1:7901 4TH AVE
Mailing Address - Street 2:APT A4
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3915
Mailing Address - Country:US
Mailing Address - Phone:718-748-1334
Mailing Address - Fax:718-748-0747
Practice Address - Street 1:7901 4TH AVE
Practice Address - Street 2:APT A4
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3915
Practice Address - Country:US
Practice Address - Phone:718-748-1334
Practice Address - Fax:718-748-0747
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-15
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW9L401Medicare PIN