Healthcare Provider Details

I. General information

NPI: 1437398237
Provider Name (Legal Business Name): RICHARD JOSEPH LAZAUSKAS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2009
Last Update Date: 02/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 PEARL ST
ALLENTOWN NJ
08501-1647
US

IV. Provider business mailing address

27 PEARL ST
ALLENTOWN NJ
08501-1647
US

V. Phone/Fax

Practice location:
  • Phone: 609-223-0365
  • Fax:
Mailing address:
  • Phone: 609-223-0365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00408800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: