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General NPI Number Information
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NPI Number | 1740324987
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Entity Type | Individual
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Provider Name | HANA M LAZNICKOVA M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 07/16/2007
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Provider Practice Location Address
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Address Line | 16 CLARKE ST
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City | LEXINGTON
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State | MA
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Zip | 02421-4988
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Country | US
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Telephone | 781-861-2049
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Fax | 781-861-1502
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Provider Business Mailing Address
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Address Line | 16 CLARKE ST
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City | LEXINGTON
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State | MA
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Zip | 02421-4988
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Country | US
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Telephone | 781-861-2049
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Fax | 781-861-1502
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 155111
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | 155111
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 207KI0005X
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Taxonomy Name | Clinical & Laboratory Immunology (Allergy & Immunology) Physician
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License Number | 155111
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License Number State | MA
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