Lazo, Eleonor Gutierrez

Lazo, Eleonor Gutierrez is an individual health care provider with primary practice located at 400 West Main Street Suite 328, Babylon NY 11702. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Lazo, Eleonor Gutierrez can be contacted via phone (631) 376-1002.

Contact Information

Primary practice address
400 West Main Street Suite 328 Babylon NY 11702
Phone: (631) 376-1002
Fax: (631) 376-1004
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 197684 New York

Profile Details

NPI number 1639264997
LBN Legal business name Lazo, Eleonor Gutierrez
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639264997 NPPES
New York MEDICAID 01619781

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