MEDICARE: MS. LANE MARIE KNIGHT NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F346223-01	NY

General Provider Information

NPI Number	:	1235730102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LANE MARIE KNIGHT NP

Provider Business Mailing Address
First Line	:	5000 BRITTONFIELD PKWY # 130
Second Line	:
City	:	EAST SYRACUSE
State	:	NY
Zip	:	13057-9226
Country	:	US
Telephone Number	:	315-634-5550
Fax Number	:

Provider Business Practice Location Address
First Line	:	5000 BRITTONFIELD PARKWAY SUITEA 130
Second Line	:
City	:	EAST SYRACUSE
State	:	NY
Zip	:	13057-1305
Country	:	US
Telephone Number	:	315-634-5550
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2020
Last Update Date	:	02/07/2023

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