Healthcare Provider Details

I. General information

NPI: 1588846455
Provider Name (Legal Business Name): ANN LANG MA OTR CHT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 09/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 W END AVE APT 1C
NEW YORK NY
10023-2613
US

IV. Provider business mailing address

263 W END AVE APT 1C
NEW YORK NY
10023-2613
US

V. Phone/Fax

Practice location:
  • Phone: 212-787-6585
  • Fax: 212-501-0238
Mailing address:
  • Phone: 212-787-6585
  • Fax: 212-501-0238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: ANN LANG
Title or Position: CERTIFIED HAND THERAPIST OCCUPATION
Credential: MA OTR CHT
Phone: 212-787-6585