Healthcare Provider Details

I. General information

NPI: 1568441988
Provider Name (Legal Business Name): AMY D. LAZAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 US HIGHWAY 22 FL 3
BRIDGEWATER NJ
08807-2560
US

IV. Provider business mailing address

660 WHITE PLAINS RD FL 4
TARRYTOWN NY
10591-5139
US

V. Phone/Fax

Practice location:
  • Phone: 908-722-1022
  • Fax: 908-722-2040
Mailing address:
  • Phone: 914-984-2546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number25MA06699600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: