MEDICARE: DR. KAREN J LAZAR PHD

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	102L00000X	Psychoanalyst	000736-1	NY
2	103TC2200X	Clinical Child & Adolescent Psychologist	35S100395500	NJ
3	103TH0004X	Health Psychologist	35S100395500	NJ
4	103TC0700X	Clinical Psychologist	35S100395500	NJ

General Provider Information

NPI Number	:	1568583144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN J LAZAR PHD

Provider Business Mailing Address
First Line	:	108 ORANGE RD
Second Line	:
City	:	MONTCLAIR
State	:	NJ
Zip	:	07042-2133
Country	:	US
Telephone Number	:	973-746-9433
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 ORANGE RD
Second Line	:
City	:	MONTCLAIR
State	:	NJ
Zip	:	07042-2133
Country	:	US
Telephone Number	:	973-746-9433
Fax Number	:

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

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	06/05/2025

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