MEDICARE: DANIE LAZARRE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SL0600X	Long-Term Care Clinical Nurse Specialist	962769-01	NY

General Provider Information

NPI Number	:	1568394922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIE LAZARRE

Provider Business Mailing Address
First Line	:	101 WELLINGTON RD
Second Line	:
City	:	ELMONT
State	:	NY
Zip	:	11003-1416
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 WELLINGTON RD
Second Line	:
City	:	ELMONT
State	:	NY
Zip	:	11003-1416
Country	:	US
Telephone Number	:	347-965-2050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ DANIE LAZARRE ” Practice Location

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