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General NPI Number Information
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NPI Number | 1104236199
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Entity Type | Organization
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Legal Business Name | SEAN WAYNE LAZARUS D.P.M. LLC
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 09/27/2025
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Provider Practice Location Address
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Address Line | 764 CAMPELLE AVE UNITG
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City | WEST HAVEN
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State | CT
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Zip | 06516-3786
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Country | US
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Telephone | 475-238-7400
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Fax | 475-238-7400
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Provider Business Mailing Address
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Address Line | 764 CAMPELLE AVE UNIT G
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City | WEST HAVEN
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State | CT
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Zip | 06516-3786
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Country | US
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Telephone | 475-238-7400
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Fax | 475-238-7400
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. SEAN WAYNE LAZARUS
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Credential | D.P.M
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Telephone | 203-453-0704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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