Basic Information
| Provider Information | |||||||||
| NPI: | 1508986613 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAZAROWICZ | ||||||||
| FirstName: | CAROLYN | ||||||||
| MiddleName: | A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 505 PATTERSON AVE | ||||||||
| Address2: | |||||||||
| City: | BAY CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 487064192 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897469633 | ||||||||
| FaxNumber: | 9897469634 | ||||||||
| Practice Location | |||||||||
| Address1: | 2480 SLOAN RD | ||||||||
| Address2: | |||||||||
| City: | BIRCH RUN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 484158934 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897469633 | ||||||||
| FaxNumber: | 9897469634 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0809X | 4704184286 | MI | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Adult |
No ID Information.