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Individual
BRANDON LAZARUS
Active
Individual
BRANDON LAZARUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
022925-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022925-1
NEW YORK STATE LICENSE
NY
Enumeration date
10/31/2018
Last updated
10/31/2018
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