Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 25MA10009500 | NJ |
NPI | 1093894297 |
---|---|
Provider Name | Laurie Kane |
First Address | Manahawkin, NJ 08050-2475 |
Second Address | Manahawkin, NJ 08050-2475 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 03/12/2019 |