Provider Demographics
NPI:1750488466
Name:LANE, GREGORY J (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:J
Last Name:LANE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:90 MATAWAN RD STE 302
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2653
Mailing Address - Country:US
Mailing Address - Phone:732-441-7177
Mailing Address - Fax:732-441-7165
Practice Address - Street 1:1907 OAK TREE RD STE 201
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2070
Practice Address - Country:US
Practice Address - Phone:732-548-7332
Practice Address - Fax:732-548-7350
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2024-08-23
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05400300207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
E40072Medicare UPIN
643104BBFMedicare ID - Type Unspecified