MEDICARE: KERI MARIE LAVIGNE-LANGENSTEIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	MD058349L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1122995	OTHER	PA	KEYSTONE MERCY
2	2Y1545	OTHER	PA	PHS HEALTH PLAN
3	2438725	OTHER	PA	AETNA US HEALTH
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	0961554000	OTHER	PA	KEYSTONE HEALTH AMER HEAL
6	157681MD058349L	OTHER	PA	HEALTH PARTNERS

General Provider Information

NPI Number	:	1225020688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERI MARIE LAVIGNE-LANGENSTEIN MD

Provider Business Mailing Address
First Line	:	PO BOX 602
Second Line	:	MARC J MEDWAY MD PC
City	:	GWYNEDD VALLEY
State	:	PA
Zip	:	19437-0602
Country	:	US
Telephone Number	:	215-542-7260
Fax Number	:	215-542-1012

Provider Business Practice Location Address
First Line	:	7600 CENTRAL AVE
Second Line	:	MARC J MEDWAY MD PC
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-2442
Country	:	US
Telephone Number	:	215-728-3736
Fax Number	:	215-728-3354

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	09/22/2011

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Directions to “ KERI MARIE LAVIGNE-LANGENSTEIN MD” Practice Location

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