Individual
KIMBERLY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
99 HIGHWAY 37 W, TOMS RIVER, NJ 08755-6423
(732) 557-8000
Mailing address
507 DOROTHY PL, BRICK, NJ 08723-8041
(845) 902-8496
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00557700
NJ
Other
Enumeration date
10/27/2019
Last updated
07/15/2024
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