| NPI | 1104236199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN WAYNE LAZARUS Doctor 203-453-0704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine |
| 213ES0131X Podiatrist, Foot Surgery | |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2016-01-04 |