Provider Demographics
NPI:1538413216
Name:LAZZARA, VERONICA MARGARET (PMHNP)
Entity type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:MARGARET
Last Name:LAZZARA
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 HICKORY DR
Mailing Address - Street 2:STE 2000
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1011
Mailing Address - Country:US
Mailing Address - Phone:781-647-6781
Mailing Address - Fax:978-531-2909
Practice Address - Street 1:2 CORPORATION WAY STE 260
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-7932
Practice Address - Country:US
Practice Address - Phone:781-647-6781
Practice Address - Fax:978-531-2909
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-02
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN277694363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health