Healthcare Provider Details

I. General information

NPI: 1700142627
Provider Name (Legal Business Name): AMI TAILOR LANGDON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMI TAILOR MD

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 02/09/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HUNTERDON PEDIATRIC ASSOCIATES 6 SAND HILL ROAD, SUITE 102
FLEMINGTON NJ
08822
US

IV. Provider business mailing address

HUNTERDON PEDIATRIC ASSOCIATES 6 SAND HILL ROAD, SUITE 102
FLEMINGTON NJ
08822
US

V. Phone/Fax

Practice location:
  • Phone: 908-782-6700
  • Fax: 908-788-5861
Mailing address:
  • Phone: 908-782-6700
  • Fax: 908-788-5861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number074381
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: