Healthcare Provider Details

I. General information

NPI: 1992829667
Provider Name (Legal Business Name): ANGELA J. LANGNER R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 ZABRISKIE ST 2B
HACKENSACK NJ
07601-4911
US

IV. Provider business mailing address

25 ZABRISKIE ST 2B
HACKENSACK NJ
07601-4911
US

V. Phone/Fax

Practice location:
  • Phone: 973-670-3103
  • Fax:
Mailing address:
  • Phone: 973-670-3103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: