Lane, Sandra Jo
Lane, Sandra Jo is an sole proprietor health care provider with primary practice located at 627 Half Hollow Rd , Dix Hills NY 11746-6233. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Lane, Sandra Jo can be contacted via phone (631) 586-7429.Contact Information
Primary practice address
627 Half Hollow Rd
Dix Hills NY 11746-6233
Phone: (631) 586-7429
Fax: (631) 254-1228
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | NYSR28454 | New York |
Profile Details
| NPI number | 1942301056 |
|---|---|
| LBN Legal business name | Lane, Sandra Jo |
| Credentials | LCSW, BCD, CGP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 25th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942301056 | NPPES |
| New York | MEDICAID | 02734485 |
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