Healthcare Provider Details

I. General information

NPI: 1205356540
Provider Name (Legal Business Name): LINDSAY LAZARUS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 07/07/2021
Certification Date: 07/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 E EVESHAM RD STE A-1
VOORHEES NJ
08043-9590
US

IV. Provider business mailing address

2401 E EVESHAM RD STE A-1
VOORHEES NJ
08043-9590
US

V. Phone/Fax

Practice location:
  • Phone: 856-424-3323
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA11032900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMT214004
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: