# LAZCANO PROCARE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033599600
- **Authorized official:** IRENE ENRIQUEZ LAZCANO R.P.T. (VICE PRESIDENT)
- **Authorized official phone:** (646) 262-9876

## Contact information

- **Practice address:** 5852 43RD AVE \# 2R, WOODSIDE, NY 11377-4852
- **Practice address phone:** (718) 305-2173
- **Practice address fax:** (718) 305-2173
- **Mailing address:** 5852 43RD AVE \# 2R, WOODSIDE, NY 11377-4852
- **Mailing address phone:** (718) 305-2173
- **Mailing address fax:** (718) 305-2173

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 024082 | NY | Yes |

## Other

- **Enumeration date:** 06/08/2015
- **Last updated:** 06/08/2015