Healthcare Provider Details

I. General information

NPI: 1578766234
Provider Name (Legal Business Name): JANE ELIZABETH LANGFITT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 07/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 PARKER HILL AVE STE 501
BOSTON MA
02120-2847
US

IV. Provider business mailing address

1575 TREMONT ST
BOSTON MA
02120-1677
US

V. Phone/Fax

Practice location:
  • Phone: 617-754-5000
  • Fax:
Mailing address:
  • Phone: 704-562-1889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA5054
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: