Individual
ELIZABETH LAZARUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-5174
(401) 453-8220
Mailing address
125 METRO CENTER BLVD STE 2000, WARWICK, RI 02886-1785
(401) 432-2520
(401) 453-8220
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
10057
RI
2085R0202X
Diagnostic Radiology Physician
203887
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000001988
NHPRI
—
01
—
003116391
CT MED ASSISTANCE
—
01
—
007007230
HOSPITAL PIN
—
01
—
010057
BCBS
—
01
—
0162001
MEDICAID
MA
01
—
0162001
HEALTHY START
—
01
—
1600025
UNITED HEALTH PLUS
—
01
—
241367
RIH PILGRIM
—
01
—
300103355
RR MEDICARE
—
01
—
400906
TUFTS
—
01
—
405083
BLUE CHIP
—
01
—
7007222
RI MEDICAL ASSISTANCE
—
01
—
720086801
CIGNA
—
Enumeration date
10/13/2005
Last updated
03/07/2024
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