Provider Demographics
NPI:1942249602
Name:LANE, CATHERINE S (PT, DPT, MS)
Entity Type:Individual
Prefix:MISS
First Name:CATHERINE
Middle Name:S
Last Name:LANE
Suffix:
Gender:F
Credentials:PT, DPT, MS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:33 POND AVE
Mailing Address - Street 2:APT. 821
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7163
Mailing Address - Country:US
Mailing Address - Phone:617-899-5977
Mailing Address - Fax:617-731-9175
Practice Address - Street 1:653 SUMMER ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02210-2108
Practice Address - Country:US
Practice Address - Phone:617-269-6262
Practice Address - Fax:617-269-1068
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1984225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA8211OtherNEIGHBORHOOD HEALTH PLAN
MAUNITED HEALTHCAREOtherUNITED HEALTHCARE
MAY66576OtherBLUE CROSS
MA467875OtherTUFTS
MA603413OtherHARVARD PILGRIM
MALAY68242Medicare ID - Type Unspecified