Healthcare Provider Details

I. General information

NPI: 1831294768
Provider Name (Legal Business Name): LAWRENCE Z LAZOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 12/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 SEYMOUR ST SUITE 1019
HARTFORD CT
06106-5501
US

IV. Provider business mailing address

PO BOX 587
ROCKY HILL CT
06067-0587
US

V. Phone/Fax

Practice location:
  • Phone: 860-246-4029
  • Fax: 860-240-7072
Mailing address:
  • Phone: 860-258-3480
  • Fax: 860-571-6800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number032849
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: