Individual
DOMENICO LAZZARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 SUPERIOR AVE, MUNSTER, IN 46321-4037
(219) 934-2085
Mailing address
PO BOX 957, SCHERERVILLE, IN 46375-0957
(800) 756-5986
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01026137A
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00207505
RAILROAD MEDICARE
—
Enumeration date
04/13/2006
Last updated
11/30/2007
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