Individual
PATRICIA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
185 GENESEE ST, SUITE 600, UTICA, NY 13501-2199
(315) 793-8806
(315) 793-8046
Mailing address
185 GENESEE ST, SUITE 600, UTICA, NY 13501-2199
(315) 793-8806
(315) 793-8046
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
174555
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01210526
—
NY
05
—
01647929
—
NY
01
—
040426013907
FIDELIS
NY
01
—
10044522
CDPHP
NY
01
—
174555-3
WC
NY
01
—
225110
MVP
NY
01
—
300021950
RAIL ROAD MEDICARE
NY
01
—
4102765
GHI
NY
01
—
P010174555
BCBS
NY
Enumeration date
07/14/2006
Last updated
01/26/2012
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