Individual
MARY LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
303 E MAIN ST, BEACON, NY 12508-3544
(845) 546-6046
Mailing address
303 E MAIN ST, BEACON, NY 12508-3544
(845) 546-6046
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
484556
NY
Other
Enumeration date
04/11/2025
Last updated
04/11/2025
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