Healthcare Provider Details

I. General information

NPI: 1245689967
Provider Name (Legal Business Name): DANIELLE J LAZARAKIS WHE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 06/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 SUNNY RIDGE RD
HARRISON NY
10528-1521
US

IV. Provider business mailing address

235 SUNNY RIDGE RD
HARRISON NY
10528-1521
US

V. Phone/Fax

Practice location:
  • Phone: 914-384-4754
  • Fax: 914-921-1919
Mailing address:
  • Phone: 914-384-4754
  • Fax: 914-921-1919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: