MEDICARE: ELIZABETH L 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	2085R0202X	Diagnostic Radiology Physician	25MA06571100	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	300102250	OTHER	NJ	RAILROAD MEDICARE - WARREN
2	300102250	OTHER	NJ	RAILROAD MEDICARE - SMC
3	300076935	OTHER	NJ	RAILROAD MEDICARE - EDISON
4	300102240	OTHER	NJ	RAILROAD MEDICARE - BRIDGEWATER

Other Identifiers

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

General Provider Information

NPI Number	:	1932105814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH L LANE MD

Provider Business Mailing Address
First Line	:	579A CRANBURY RD
Second Line	:
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-5426
Country	:	US
Telephone Number	:	732-390-0040
Fax Number	:	732-390-1856

Provider Business Practice Location Address
First Line	:	16 MOUNTAIN BLVD
Second Line	:
City	:	WARREN
State	:	NJ
Zip	:	07059-5614
Country	:	US
Telephone Number	:	908-769-7200
Fax Number	:	908-769-9141

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

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	12/13/2016

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Directions to “ ELIZABETH L LANE MD” Practice Location

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