MEDICARE: AMY LAZARO RN, BSN, IBCLC

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
1	363LP2300X	Primary Care Nurse Practitioner	RN258551	MA

General Provider Information

NPI Number	:	1083031587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY LAZARO RN, BSN, IBCLC

Provider Business Mailing Address
First Line	:	57 BEDFORD ST STE 100
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02420-4550
Country	:	US
Telephone Number	:	978-424-8440
Fax Number	:

Provider Business Practice Location Address
First Line	:	57 BEDFORD ST STE 100
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02420-4550
Country	:	US
Telephone Number	:	978-424-8440
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2014
Last Update Date	:	05/19/2025

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