Healthcare Provider Details
I. General information
NPI: 1700032133
Provider Name (Legal Business Name): RACHEL SUTTON LAZARO AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/18/2008
Last Update Date: 08/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1915 K M WICKER MEMORIAL DR
SANFORD NC
27330-5070
US
IV. Provider business mailing address
115 PARKWAY OFFICE CT STE 100
CARY NC
27518-7431
US
V. Phone/Fax
- Phone: 919-774-6829
- Fax: 919-775-2327
- Phone: 919-851-3803
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237600000X |
| Taxonomy | Audiologist-Hearing Aid Fitter |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: