Healthcare Provider Details

I. General information

NPI: 1780245910
Provider Name (Legal Business Name): DANIELLE LAZARO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2019
Last Update Date: 06/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1088 HIGHWAY 34
ABERDEEN NJ
07747-1948
US

IV. Provider business mailing address

1088 HIGHWAY 34
ABERDEEN NJ
07747-1948
US

V. Phone/Fax

Practice location:
  • Phone: 732-290-1700
  • Fax: 732-696-9998
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number26NR18343800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: