Individual
KRISTINE CARTA LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
540 SAYBROOK RD STE 110, MIDDLETOWN, CT 06457-4711
(860) 740-2280
Mailing address
15 TRAILSIDE XING, MIDDLETOWN, CT 06457-5465
(860) 559-8460
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001986
CT
Other
Enumeration date
11/06/2007
Last updated
11/13/2017
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