Individual
MARY P LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
STONY BROOK UNIV MED ICAL CTR, T12, 080 HEALTH SCIENCE CENTER, STONY BROOK, NY 11794-0001
(631) 444-1210
(631) 444-1535
Mailing address
STONY BROOK UNIV MED ICAL CTR, T12, 080 HEALTH SCIENCE CENTER, STONY BROOK, NY 11794-0001
(631) 444-1210
(631) 444-1535
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F300770
NY
363LP0200X
Pediatric Nurse Practitioner
F380761
NY
Other
Enumeration date
06/08/2008
Last updated
06/08/2008
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