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1730614207
JAIMIE LANE
SELDEN, NY
NPI
1730614207
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Former Name
JAIMIE OTTONE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
Enumeration Date
2017-04-21
Last Update Date
2017-04-24
Business Address
-- JAIMIE LANE M.S
51 KING AVE
SELDEN, NY 11784-2343
Phone number: 631-553-0667
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Mailing Address
-- JAIMIE LANE M.S
51 KING AVE
SELDEN, NY 11784-2343
Phone number: 631-553-0667
Copy
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