Healthcare Provider Details

I. General information

NPI: 1558786186
Provider Name (Legal Business Name): LOUIS JAMES LAZZARA JR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2014
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 N WASHINGTON ST
BUTLER PA
16001-5241
US

IV. Provider business mailing address

216 N WASHINGTON ST
BUTLER PA
16001-5241
US

V. Phone/Fax

Practice location:
  • Phone: 724-968-5310
  • Fax: 724-431-4703
Mailing address:
  • Phone: 724-968-5310
  • Fax: 724-421-5842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0102204205
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: