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General NPI Number Information
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NPI Number | 1366676363
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Entity Type | Individual
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Provider Name | LANE MICHELLE DAILEY RD
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Gender | Female
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Dates
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Enumeration Date | 05/06/2009
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Last Update Date | 11/11/2010
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Provider Practice Location Address
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Address Line | 525 E 68TH ST BOX #92
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City | NEW YORK
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State | NY
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Zip | 10065-4870
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Country | US
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Telephone | 212-746-1011
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Fax | 212-746-9456
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Provider Business Mailing Address
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Address Line | 1 COLUMBUS PL N 49C
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City | NEW YORK
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State | NY
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Zip | 10019-8201
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Country | US
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Telephone | 415-264-1775
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 006700
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License Number State | NY
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