Healthcare Provider Details

I. General information

NPI: 1730117144
Provider Name (Legal Business Name): RONALD LANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 06/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

984 N BROADWAY SUITE 312
YONKERS NY
10701-1318
US

IV. Provider business mailing address

26 FIREMENS MEMORIAL DR 115
POMONA NY
10970-3553
US

V. Phone/Fax

Practice location:
  • Phone: 914-376-2372
  • Fax: 914-968-8975
Mailing address:
  • Phone: 800-750-8616
  • Fax: 845-362-8474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number127676
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: