Healthcare Provider Details

I. General information

NPI: 1942334040
Provider Name (Legal Business Name): BETTE LAZZARO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 S GOVERNORS AVE
DOVER DE
19904-4158
US

IV. Provider business mailing address

298 FOX RUN
EXTON PA
19341-2119
US

V. Phone/Fax

Practice location:
  • Phone: 302-888-0213
  • Fax: 610-524-8099
Mailing address:
  • Phone: 215-432-3099
  • Fax: 610-524-8099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberC1-0006098
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: