Healthcare Provider Details

I. General information

NPI: 1972121382
Provider Name (Legal Business Name): STEPHEN DALE LAZAR JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2020
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S CEDAR CREST BLVD
ALLENTOWN PA
18103-6202
US

IV. Provider business mailing address

PO BOX 16052
READING PA
19612-6052
US

V. Phone/Fax

Practice location:
  • Phone: 610-402-8000
  • Fax:
Mailing address:
  • Phone: 484-628-8333
  • Fax: 484-628-8334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberOT020366
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberOS024053
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: