| Angel Lazo Md, Pa | |
|
55 Meadowlands Pkwy Fl 3 Secaucus NJ 07094-2977 | |
| (201) 978-7740 | |
| (201) 392-3514 |
| Full Name | Angel Lazo Md, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 55 Meadowlands Pkwy Fl 3, Secaucus, New Jersey |
| Authorized Official Name and Position | Angel Lazo (OWNER) |
| Authorized Official Contact | 9089639919 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angel Lazo Md, Pa Po Box 4335 Warren NJ 07059-0335 Ph: (908) 963-9919 | Angel Lazo Md, Pa 55 Meadowlands Pkwy Fl 3 Secaucus NJ 07094-2977 Ph: (201) 978-7740 |
| NPI Number | 1154638211 |
|---|---|
| Provider Enumeration Date | 09/09/2010 |
| Last Update Date | 05/28/2015 |
| Medicare PECOS PAC ID | 0749450583 |
|---|---|
| Medicare Enrollment ID | O20110902000399 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154638211 | NPI | - | NPPES |
| 8394709 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MA70523 (New Jersey) | Primary |
| Provider Name | Angel A Lazo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932168523 PECOS PAC ID: 8426941329 Enrollment ID: I20040204000958 |
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