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Individual
MR. KEVIN A LANE SR.
Active
Individual
MR. KEVIN A LANE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002999
GA
363A00000X
Physician Assistant
Primary
005639
NY
363A00000X
Physician Assistant
2978
WV
363A00000X
Physician Assistant
C0003531
MD
363AM0700X
Medical Physician Assistant
005639
NY
Other
Enumeration date
08/19/2006
Last updated
01/28/2025
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