Provider Demographics
NPI:1487123675
Name:LAZARE, ADRIANA
Entity type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:
Last Name:LAZARE
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 1:18 TENNESSEE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-1320
Mailing Address - Country:US
Mailing Address - Phone:347-426-6661
Mailing Address - Fax:
Practice Address - Street 1:18 TENNESSEE AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-1320
Practice Address - Country:US
Practice Address - Phone:347-426-6661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013142111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor