Individual
CAROLYN LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16 BAY BLVD, NEWARK, DE 19702-4800
(917) 517-6639
Mailing address
16 BAY BLVD, NEWARK, DE 19702-4800
(917) 517-6639
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
270763 -1
NY
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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