Provider Demographics
NPI:1396505459
Name:LAZAR, ANN
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:LAZAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 HAMPSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-2406
Mailing Address - Country:US
Mailing Address - Phone:248-431-5702
Mailing Address - Fax:
Practice Address - Street 1:6422 SILVERBROOK W
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-1034
Practice Address - Country:US
Practice Address - Phone:248-431-5702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide