Individual
MS. JENNIFER LAZAROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NP
Contact information
Practice address
115 BROADWAY STE 1800, NEW YORK, NY 10006-1652
(516) 534-2375
(512) 229-0865
Mailing address
39 WEST 14TH STREET, SUITE 506, NEW YORK, NY 10011
(929) 777-0173
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
673578-1
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
402087
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402087-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00695941
—
NY
Enumeration date
07/15/2015
Last updated
12/06/2019
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