Healthcare Provider Details

I. General information

NPI: 1790309391
Provider Name (Legal Business Name): SARAH H LAZAROS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2020
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W 57TH ST STE 404
NEW YORK NY
10019-3147
US

IV. Provider business mailing address

315 W 57TH ST STE 404
NEW YORK NY
10019-3147
US

V. Phone/Fax

Practice location:
  • Phone: 888-603-9338
  • Fax: 212-313-9467
Mailing address:
  • Phone: 888-603-9338
  • Fax: 212-313-9467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number324084
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: