Individual
AMY NELLIE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8 CENTURY HILL DR, LATHAM, NY 12110-2193
(518) 783-7173
(518) 783-5426
Mailing address
7 OVERLOOK DR, WYNANTSKILL, NY 12198-7458
(845) 518-4471
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
343195
NY
Other
Enumeration date
08/06/2018
Last updated
08/06/2018
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