Individual
DR. MEGAN LOLA RIDLEY-LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
635 W 165TH ST, NEW YORK, NY 10032-3724
(212) 305-3015
Mailing address
635 W 165TH ST, NEW YORK, NY 10032-3724
(212) 305-3015
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
283149
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04408706
—
NY
Enumeration date
05/27/2012
Last updated
05/04/2017
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