Healthcare Provider Details

I. General information

NPI: 1023206000
Provider Name (Legal Business Name): BARRY W. LANGSAM, D.D.S.,PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 QUAKER RIDGE RD 212
NEW ROCHELLE NY
10804-2808
US

IV. Provider business mailing address

77 QUAKER RIDGE RD 212
NEW ROCHELLE NY
10804-2808
US

V. Phone/Fax

Practice location:
  • Phone: 914-235-1235
  • Fax: 914-235-0194
Mailing address:
  • Phone: 914-235-1235
  • Fax: 914-235-0194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number23634
License Number StateNY

VIII. Authorized Official

Name: DR. BARRY W LANGSAM
Title or Position: OWNER
Credential: D.D.S.
Phone: 914-235-1235