Individual provider Active NPI

Marcilene Lazarus

  • Physical Therapist
  • Webster, NY
National Provider Identifier
1548517857
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
039388 Issued in NY
Practice address
452 Pellett Rd
Webster, NY 14580-1526
Phone
(716) 713-1191
NPI assigned
Aug 7, 2012
Last updated
Feb 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 039388 NY Primary

Addresses

Primary practice location

452 Pellett Rd
Webster, NY 14580-1526

Mailing address

452 Pellett Rd
Webster, NY 14580-1526
Phone (716) 713-1191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
039388NYMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1548517857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 PELLETT RD",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145801526",
            "telephone_number": "716-713-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 PELLETT RD",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145801526",
            "telephone_number": "716-713-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARUS",
        "first_name": "MARCILENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-07",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.