Basic Information
| Provider Information | |||||||||
| NPI: | 1386691012 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAZOWSKI | ||||||||
| FirstName: | PIOTR | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 47 OBERY STREET | ||||||||
| Address2: | SUITE 1A | ||||||||
| City: | PLYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023602229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5087474883 | ||||||||
| FaxNumber: | 5087476661 | ||||||||
| Practice Location | |||||||||
| Address1: | 47 OBERY STREET | ||||||||
| Address2: | SUITE 1A | ||||||||
| City: | PLYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023602229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5087474883 | ||||||||
| FaxNumber: | 5087476661 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2006 | ||||||||
| LastUpdateDate: | 10/11/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 203175 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | 203175 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 69545 | 01 | MA | HARVARD PILGRIM HEALTH | OTHER | 110247713 | 01 | MA | RAILROAD MEDICARE | OTHER | J21812 | 01 | MA | BLUE SHIELD | OTHER | 203175 | 01 | MA | US FAMILY SPECIALIST | OTHER | 2240855 | 01 | MA | AETNA - INT MED | OTHER | 2240860 | 01 | MA | AETNA - NEPHROLOGY | OTHER | 203175 | 01 | MA | TUFTS MEDICARE PREFERRED | OTHER | 30668 | 01 | MA | BMC HEALTHNET SPECIALIST | OTHER | A30336 | 01 | MA | MEDICARE | OTHER | 203175 | 01 | MA | TUFTS HEALTH PLAN | OTHER | 3201147 | 05 | MA | MEDICAID | 491317 | 01 | MA | US FAMILY PCP | OTHER | 804490304 | 01 | MA | CIGNA | OTHER |