Individual
DR. EDWARD MICHAEL LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4675 MAIN STREET, BRIDGEPORT, CT 06606
(203) 372-0009
(203) 372-7931
Mailing address
300 GEORGE ST, FL 6, NEW HAVEN, CT 06511-6624
(203) 785-6610
(203) 785-6414
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
024213
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001242031
—
CT
Enumeration date
07/06/2006
Last updated
05/02/2016
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