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General NPI Number Information
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NPI Number | 1235730102
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Entity Type | Individual
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Provider Name | LANE MARIE KNIGHT NP
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Gender | Female
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Dates
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Enumeration Date | 11/05/2020
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 5000 BRITTONFIELD PARKWAY SUITEA 130
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City | EAST SYRACUSE
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State | NY
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Zip | 13057-1305
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Country | US
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Telephone | 315-634-5550
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 BRITTONFIELD PKWY # 130
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City | EAST SYRACUSE
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State | NY
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Zip | 13057-9226
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Country | US
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Telephone | 315-634-5550
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F346223-01
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License Number State | NY
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