Healthcare Provider Details

I. General information

NPI: 1912962481
Provider Name (Legal Business Name): BIANCA J LANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 04/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR SLEEP DISORDERS CENTER
LEBANON NH
03756-1000
US

IV. Provider business mailing address

1 MEDICAL CENTER DR SLEEP DISORDERS CENTER
LEBANON NH
03756-1000
US

V. Phone/Fax

Practice location:
  • Phone: 603-650-7534
  • Fax:
Mailing address:
  • Phone: 603-650-7534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number13406
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number13406
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: