Provider Demographics
NPI:1366415135
Name:LANE, HOWARD ADAM (MD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:ADAM
Last Name:LANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1981 MARCUS AVE STE E115
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1038
Mailing Address - Country:US
Mailing Address - Phone:516-627-5113
Mailing Address - Fax:516-365-2817
Practice Address - Street 1:1981 MARCUS AVE STE E115
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1038
Practice Address - Country:US
Practice Address - Phone:516-627-5113
Practice Address - Fax:513-365-2817
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY212402207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH34636Medicare UPIN
NY427B234001Medicare PIN
NY427B21Medicare ID - Type Unspecified