Individual
DR. RONALD M. LAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
710 W 168TH STREET, NEW YORK, NY 10032-2699
(212) 305-4749
(212) 305-3741
Mailing address
710 W 168TH STREET, NEW YORK, NY 10032-2699
(212) 305-4749
(212) 305-3741
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
7023
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01622155
—
NY
Enumeration date
09/29/2006
Last updated
05/30/2012
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