Provider Demographics
NPI:1588129852
Name:LAZO, STEVE
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:LAZO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3210 GREENPOINT AVE
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-2010
Mailing Address - Country:US
Mailing Address - Phone:718-706-6234
Mailing Address - Fax:718-706-6239
Practice Address - Street 1:3210 GREENPOINT AVE
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-2010
Practice Address - Country:US
Practice Address - Phone:718-706-6234
Practice Address - Fax:718-706-6239
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYB02969207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services