MEDICARE: DR. STEPHEN LAZAR MD

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	207R00000X	Internal Medicine Physician	176285	NY
2	207RC0000X	Cardiovascular Disease Physician	176285	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	060048910	OTHER	NY	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	25F913K222	OTHER	NY	PTAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811990872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN LAZAR MD

Provider Business Mailing Address
First Line	:	PO BOX 5801
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10087-5801
Country	:	US
Telephone Number	:	914-593-7880
Fax Number	:	914-593-7881

Provider Business Practice Location Address
First Line	:	575 HUDSON VALLEY AVE
Second Line	:	STE 200
City	:	NEW WINDSOR
State	:	NY
Zip	:	12553-4746
Country	:	US
Telephone Number	:	845-561-2773
Fax Number	:	914-593-7881

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	04/16/2021

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Directions to “ DR. STEPHEN LAZAR MD” Practice Location

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