Active NPI
Michael Lazarou
- Physical Therapy Assistant
- Ballston Spa, NY
National Provider Identifier
1831545805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 002862-1
- Practice address
- 16 Saratoga Bridges Blvd
Ballston Spa, NY 12020-6236 - Phone
- (518) 373-1383
- Fax
- (518) 373-1387
- NPI assigned
- May 10, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 002862-1 | NY | Primary |
Addresses
Primary practice location
16 Saratoga Bridges Blvd
Ballston Spa, NY 12020-6236
Mailing address
16 Saratoga Bridges Blvd
Ballston Spa, NY 12020-6236
Phone (518) 373-1383
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002862-1 | NY | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462838400000",
"number": "1831545805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 SARATOGA BRIDGES BLVD",
"city": "BALLSTON SPA",
"state": "NY",
"postal_code": "120206236",
"telephone_number": "518-373-1383",
"fax_number": "518-373-1387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 SARATOGA BRIDGES BLVD",
"city": "BALLSTON SPA",
"state": "NY",
"postal_code": "120206236",
"telephone_number": "518-373-1383",
"fax_number": "518-373-1387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAZAROU",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-10",
"last_updated": "2016-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NY",
"license": "002862-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ballston Spa, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.