Matthew Watkins Lazar, PA-C
Physician Assistant in Sunnyside, NY. Individual provider (NPI-1).
NPI number1144690405
StatusActive
Last updated in NPPESSep 30, 2015
Details
- NPI
- 1144690405
- Entity type
- Individual (NPI-1)
- Name
- Matthew Watkins Lazar
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 30, 2015
- Last updated
- Sep 30, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 019172 | NY | Yes |
Practice location
3941 50th Ave2nd Fl
Sunnyside, NY 11104-4108
Phone 904-228-8611
Mailing address
3941 50th Ave2nd Fl
Sunnyside, NY 11104-4108
Phone 904-228-8611
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