Individual
IRIS LAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DH
Contact information
Practice address
101 S BERGEN PL, FREEPORT, NY 11520-3528
(516) 623-3600
(516) 623-9191
Mailing address
1600 STEWART AVE STE 300, WESTBURY, NY 11590-6611
(516) 396-0187
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
028320
NY
Other
Enumeration date
08/21/2020
Last updated
08/21/2020
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