Most Relevant Information
Provider Data
| NPI Number: | 1003198623 |
| Provider Name: | LISA LANE |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/10/2011 |
| Last Updated: | 06/06/2019 |
Provider Practice Location
6701 110TH ST
FOREST HILLS
NY
113752378
Practice Location Phone/Fax
| Phone: | 7182683137 |
| Fax: |
Provider Mailing Location
298 BROMPTON RD S
GARDEN CITY
NY
115305417
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |