Provider Demographics
NPI:1699759233
Name:LAZAROSKI, CIRE (DC)
Entity type:Individual
Prefix:DR
First Name:CIRE
Middle Name:
Last Name:LAZAROSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 E 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-2576
Mailing Address - Country:US
Mailing Address - Phone:219-947-0016
Mailing Address - Fax:219-947-5651
Practice Address - Street 1:1733 E 37TH AVE
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-2576
Practice Address - Country:US
Practice Address - Phone:219-947-0016
Practice Address - Fax:219-947-5651
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001944111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000194681OtherBS
IN200293860AMedicaid
352128560OtherSAGAMORE
352128560OtherHUMANA CHOICE
50433OtherUNIVERSAL HS
9138729OtherPHCS
2547571OtherAETNA
9138729OtherPHCS
2547571OtherAETNA