MEDICARE: LAZAROU UROLOGY ASSOCIATES, PC

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	208800000X	Urology Physician	220000	MA

General Provider Information

NPI Number	:	1275706673
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAZAROU UROLOGY ASSOCIATES, PC

Provider Business Mailing Address
First Line	:	10 NEHOIDEN STREET
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02492-1932
Country	:	US
Telephone Number	:	617-777-0508
Fax Number	:

Provider Business Practice Location Address
First Line	:	65 WALNUT ST
Second Line	:	SUITE 460
City	:	WELLESLEY HILLS
State	:	MA
Zip	:	02481-2118
Country	:	US
Telephone Number	:	781-237-9000
Fax Number	:	781-237-9001

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STEPHEN A LAZAROU
Credential	:	M.D.
Telephone Number	:	617-777-0508

Provider Enumeration Date	:	04/07/2008
Last Update Date	:	03/18/2015

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