MEDICARE: MISS CATHERINE S LANE PT, DPT, MS

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	225100000X	Physical Therapist	1984	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8211	OTHER	MA	NEIGHBORHOOD HEALTH PLAN
2	UNITED HEALTHCARE	OTHER	MA	UNITED HEALTHCARE
3	Y66576	OTHER	MA	BLUE CROSS
4	467875	OTHER	MA	TUFTS
5	603413	OTHER	MA	HARVARD PILGRIM

General Provider Information

NPI Number	:	1942249602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CATHERINE S LANE PT, DPT, MS

Provider Business Mailing Address
First Line	:	33 POND AVE
Second Line	:	APT. 821
City	:	BROOKLINE
State	:	MA
Zip	:	02445-7163
Country	:	US
Telephone Number	:	617-899-5977
Fax Number	:	617-731-9175

Provider Business Practice Location Address
First Line	:	653 SUMMER ST
Second Line	:	SECOND FLOOR
City	:	BOSTON
State	:	MA
Zip	:	02210-2108
Country	:	US
Telephone Number	:	617-269-6262
Fax Number	:	617-269-1068

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	07/08/2007

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Directions to “ MISS CATHERINE S LANE PT, DPT, MS” Practice Location

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