MEDICARE: STEVEN SAUL LAZAR M.D.

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	131273	NY

General Provider Information

NPI Number	:	1932232154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN SAUL LAZAR M.D.

Provider Business Mailing Address
First Line	:	205 WEST END AVE.
Second Line	:	10B
City	:	NEW YORK
State	:	NY
Zip	:	10023
Country	:	US
Telephone Number	:	212-496-7799
Fax Number	:

Provider Business Practice Location Address
First Line	:	1518 43RD ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-1605
Country	:	US
Telephone Number	:	718-436-9111
Fax Number	:	718-436-5460

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	07/09/2007

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