Provider Demographics
NPI:1396748083
Name:LAZAR, PAUL (DPM)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:LAZAR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 3RD AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2952
Mailing Address - Country:US
Mailing Address - Phone:212-996-1400
Mailing Address - Fax:212-535-8606
Practice Address - Street 1:1317 3RD AVENUE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4256
Practice Address - Country:US
Practice Address - Phone:212-996-1400
Practice Address - Fax:212-535-8606
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005355-1213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYGHIOtherGHI
NY56955555-007OtherCIGNA
NY133967734OtherUNITED HEALTH CARE
NY133967734Other1199
NY766640OtherOXFORD HEALTH PLANS
NYU45431Medicare UPIN
NYP95441Medicare ID - Type Unspecified