Healthcare Provider Details

I. General information

NPI: 1073176863
Provider Name (Legal Business Name): ERIN LANZO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 YORK AVE FL 11
NEW YORK NY
10021-5663
US

IV. Provider business mailing address

1305 YORK AVE FL 11
NEW YORK NY
10021-5663
US

V. Phone/Fax

Practice location:
  • Phone: 646-962-2020
  • Fax:
Mailing address:
  • Phone: 646-962-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0109X
TaxonomyNeuro-ophthalmology Physician
License Number321368
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: