Individual
LAURI ANN FAIRBANKS DOANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
8100 OSWEGO ROAD, SUITE 220, LIVERPOOL, NY 13090
(315) 652-6551
(315) 652-9698
Mailing address
8100 OSWEGO ROAD, SUITE 220, LIVERPOOL, NY 13090
(315) 652-6551
(315) 652-9698
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
197300
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01918827
—
NY
01
—
080178302
RAILROAD MEDICARE
—
01
—
960897
MVP HEALTHCARE INSURER
—
Enumeration date
11/21/2006
Last updated
05/22/2008
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