MEDICARE: MICHAEL LANE MD

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	207L00000X	Anesthesiology Physician	12389	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922005073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL LANE MD

Provider Business Mailing Address
First Line	:	68 S SERVICE RD
Second Line	:	SUITE 350
City	:	MELVILLE
State	:	NY
Zip	:	11747-2354
Country	:	US
Telephone Number	:	516-945-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 WHITEHALL RD
Second Line	:	ANESTHESIA DEPARTMENT
City	:	ROCHESTER
State	:	NH
Zip	:	03867-3226
Country	:	US
Telephone Number	:	603-335-8419
Fax Number	:

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	11/02/2009

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Directions to “ MICHAEL LANE MD” Practice Location

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