Healthcare Provider Details

I. General information

NPI: 1023219748
Provider Name (Legal Business Name): CYNTHIA LANGER MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 02/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 E MAIN ST
AVON CT
06001-3829
US

IV. Provider business mailing address

62 RATLUM MOUNTAIN RD
BARKHAMSTED CT
06063-1808
US

V. Phone/Fax

Practice location:
  • Phone: 860-402-7743
  • Fax:
Mailing address:
  • Phone: 860-738-3216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004522
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: