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Contact Information

NICHOLAS A LAZZARO, MD
190 E BANNOCK
BOISE, ID83712
 Phone: 208-381-2094
 Fax: 208-381-1791
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for NICHOLAS A LAZZARO · (Male)

NPI Number 1700076619
Status Active
Credentials MD
Entity Individual
Enumeration date 07/26/2007
Last updated 07/08/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • ID License # M-11001
  • MI License # 4301082251
Hospital affiliation(s)
  • ST LUKE'S ELMORE MEDICAL CENTER - (Critical Access)
    895 NORTH 6TH EAST
    MOUNTAIN HOME, ID 83647
  • ST LUKES REGIONAL MEDICAL CENTER - (Acute Care)
    190 EAST BANNOCK STREET
    BOISE, ID 83712
  • ST LUKES WOOD RIVER MEDICAL CENTER - (Critical Access)
    100 HOSPITAL DRIVE
    KETCHUM, ID 83340
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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