Individual
DR. JOHN B. LAZOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 CONGRESS ST, SUITE 2B, QUINCY, MA 02169-0908
(617) 774-1717
Mailing address
500 CONGRESS STREET, SUITE 2-B, QUINCY, MA 02169-0960
(617) 573-3635
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
79829
MA
207YS0123X
Facial Plastic Surgery Physician
79829
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3135276
—
MA
Enumeration date
10/31/2005
Last updated
04/26/2012
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