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General NPI Number Information
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NPI Number | 1487864328
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Entity Type | Organization
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Legal Business Name | SUSAN G. LAZAR, MD, PA
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9104 QUINTANA DR
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City | BETHESDA
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State | MD
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Zip | 20817-2040
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Country | US
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Telephone | 301-365-0373
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Fax | 301-365-3240
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Provider Business Mailing Address
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Address Line | 9104 QUINTANA DR
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City | BETHESDA
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State | MD
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Zip | 20817-2040
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Country | US
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Telephone | 301-365-0373
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Fax | 301-365-3240
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUSAN GABOR LAZAR
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Credential | MD
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Telephone | 301-365-0373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | D20561
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License Number State | MD
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