Individual
DR. MARK L. LAZARUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
8737 PALERMO ST, HOLLIS, NY 11423-1221
(718) 776-8181
Mailing address
3 HIGH RIDGE CT, GLEN COVE, NY 11542-1222
(516) 458-3449
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
012094
NY
Other
Enumeration date
02/18/2009
Last updated
02/18/2009
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