Provider Demographics
NPI:1548471949
Name:LAZUSKY, HEATHER MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:MICHELLE
Last Name:LAZUSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-4240
Mailing Address - Fax:717-848-5520
Practice Address - Street 1:2050 S QUEEN ST
Practice Address - Street 2:STE 100
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4829
Practice Address - Country:US
Practice Address - Phone:717-812-4240
Practice Address - Fax:717-848-5520
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0070944208000000X
PAMD448494208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA783770OtherUPMC
PA102837857Medicaid
PA2897344OtherHIGHMARK BLUE SHIELD
PA2897344OtherHIGHMARK BLUE SHIELD