Healthcare Provider Details
I. General information
NPI: 1326373366
Provider Name (Legal Business Name): KAREN A LANGONE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/08/2009
Last Update Date: 10/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
365 COUNTY ROAD 39A SUITE 9
SOUTHAMPTON NY
11968-5284
US
IV. Provider business mailing address
365 COUNTY ROAD 39A SUITE 9
SOUTHAMPTON NY
11968-5284
US
V. Phone/Fax
- Phone: 631-287-1818
- Fax: 631-287-1838
- Phone: 631-287-1818
- Fax: 631-287-1838
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 4110 |
| License Number State | NY |
VIII. Authorized Official
Name: DR.
KAREN
A
LANGONE
Title or Position: OWNER
Credential: DPM
Phone: 631-287-1818