Provider Demographics
NPI:1316067671
Name:LANE, DAWN MAY (OTR)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MAY
Last Name:LANE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:217 POPLAR PL
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-3756
Mailing Address - Country:US
Mailing Address - Phone:732-918-8789
Mailing Address - Fax:732-295-3246
Practice Address - Street 1:1515 HULSE RD
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BORO
Practice Address - State:NJ
Practice Address - Zip Code:08742-4527
Practice Address - Country:US
Practice Address - Phone:732-295-9300
Practice Address - Fax:732-295-3246
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00012600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist