Healthcare Provider Details

I. General information

NPI: 1184728529
Provider Name (Legal Business Name): CLARE LAZAR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 12/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 BARROW ST 3RD FLOOR
NEW YORK NY
10014-3823
US

IV. Provider business mailing address

300 CENTRAL PARK W APT. #15C-1
NEW YORK NY
10024-1513
US

V. Phone/Fax

Practice location:
  • Phone: 212-242-4140
  • Fax: 212-929-9727
Mailing address:
  • Phone: 212-787-9195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number00006211
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: