MEDICARE: DR. JOEL STEVEN LAZAR M.D.

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	207Q00000X	Family Medicine Physician	12069	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639199763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL STEVEN LAZAR M.D.

Provider Business Mailing Address
First Line	:	101 TREMONT STREET, 6TH FLOOR
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02108
Country	:	US
Telephone Number	:	617-804-5981
Fax Number	:	617-701-7740

Provider Business Practice Location Address
First Line	:	7 ALLEN ST
Second Line	:
City	:	HANOVER
State	:	NH
Zip	:	03755-2065
Country	:	US
Telephone Number	:	603-738-1164
Fax Number	:	603-653-8191

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

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	03/17/2018

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