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NPI Code Detail

MEDICARE: GABRIEL LAZARIN MS

MEDICARE: GABRIEL LAZARIN MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1170300000XGenetic Counselor (M.S.)

General Provider Information

NPI Number : 1053510479
Entity Type Code : Individual
Provider Name (Legal Business Name) : GABRIEL LAZARIN MS
Provider Business Mailing Address
First Line : 5605 W EUGIE AVE STE 212
Second Line :
City : GLENDALE
State : AZ
Zip : 85304-1275
Country : US
Telephone Number : 480-551-9700
Fax Number :
Provider Business Practice Location Address
First Line : 5605 W EUGIE AVE STE 212
Second Line :
City : GLENDALE
State : AZ
Zip : 85304-1275
Country : US
Telephone Number : 480-551-9700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2007
Last Update Date : 07/16/2007

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Directions to “ GABRIEL LAZARIN MS” Practice Location

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