1063735132 NPI number — LAZUR & LAZUR, LTD.

Table of content: (NPI 1063735132)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063735132 NPI number — LAZUR & LAZUR, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAZUR & LAZUR, LTD.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063735132
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/03/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6828 LOWELL CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANCHORAGE
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99502-1849
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-562-1933
Provider Business Mailing Address Fax Number:
907-562-1931

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 E 9TH AVE STE 1A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANCHORAGE
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99501-3651
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-562-1933
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/03/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LAZUR
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
907-562-1933

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  PSY 277 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)