Doctor Name: | MRS. ALICIA E LANE |
NPI Number: | 1013338763 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC, BSN, RN |
License Number: | 26NJ00475500 |
Business Practice Address: | 751 Bergen Ave Jersey City, NJ - 073064705 |
Business Phone Number: | 2019461200 |
Business Fax Number: | |
Mailing Address: | 2520 John F Kennedy Blvd, Unit 1c JERSEY CITY |
State: | NJ |
Postal Code: | 073042054 |
Phone Number: | 7326829623 |
Fax Number: | |
NPI Enumeration Date: | 12/26/2013 |
NPI Last Update Date: | 07/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 26NJ00475500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |