Provider Demographics
NPI:1700815032
Name:PALMER, LANE S (MD)
Entity Type:Individual
Prefix:DR
First Name:LANE
Middle Name:S
Last Name:PALMER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:247 ROUTE 100
Mailing Address - Street 2:SUITE 1002
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-3231
Mailing Address - Country:US
Mailing Address - Phone:914-962-0829
Mailing Address - Fax:914-962-8851
Practice Address - Street 1:1999 MARCUS AVE
Practice Address - Street 2:SUITE M18
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1017
Practice Address - Country:US
Practice Address - Phone:516-466-6953
Practice Address - Fax:516-466-5608
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2014-01-29
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Provider Licenses
StateLicense IDTaxonomies
NY184849208800000X, 2088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY017232443Medicaid
NYF40499Medicare UPIN
NY017232443Medicaid