Healthcare Provider Details

I. General information

NPI: 1093872913
Provider Name (Legal Business Name): ANN LANG MA OTR CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2007
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 Code225XH1200X
TaxonomyHand Occupational Therapist
License Number02146 1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: