Provider Demographics
NPI:1871552158
Name:LAZARUS, ANGELINE ABRAHAM (MD)
Entity type:Individual
Prefix:DR
First Name:ANGELINE
Middle Name:ABRAHAM
Last Name:LAZARUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANGELINE
Other - Middle Name:
Other - Last Name:NITHIYANANDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:13207 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3626
Mailing Address - Country:US
Mailing Address - Phone:301-424-5752
Mailing Address - Fax:301-319-8751
Practice Address - Street 1:8901 WISCONSIN AVENUE
Practice Address - Street 2:NATIONAL NAVAL MEDICAL CENTER
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5600
Practice Address - Country:US
Practice Address - Phone:301-295-4218
Practice Address - Fax:301-319-8751
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0062654207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease