Provider Demographics
NPI:1831459080
Name:LANE, JOANNE SYLVIA (DO)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:SYLVIA
Last Name:LANE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 N WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1875
Mailing Address - Country:US
Mailing Address - Phone:609-567-0434
Mailing Address - Fax:
Practice Address - Street 1:651 HIGH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-2737
Practice Address - Country:US
Practice Address - Phone:609-386-0775
Practice Address - Fax:609-386-4372
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB11177000208000000X
VA0102204108208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics