Healthcare Provider Details

I. General information

NPI: 1831800259
Provider Name (Legal Business Name): KATHRYN ANNE LAZZARI DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2022
Last Update Date: 12/06/2022
Certification Date: 12/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 HAWTHORN HILL DR
CANONSBURG PA
15317-2843
US

IV. Provider business mailing address

461 HAWTHORN HILL DR
CANONSBURG PA
15317-2843
US

V. Phone/Fax

Practice location:
  • Phone: 724-809-3907
  • Fax:
Mailing address:
  • Phone: 724-809-3907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT021638
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: