Healthcare Provider Details

I. General information

NPI: 1457317380
Provider Name (Legal Business Name): RICHARD P. LANGO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 06/16/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 CENTER ST
RUTLAND VT
05701-4046
US

IV. Provider business mailing address

PO BOX 912
RUTLAND VT
05702-0912
US

V. Phone/Fax

Practice location:
  • Phone: 802-775-7778
  • Fax: 802-775-7775
Mailing address:
  • Phone: 802-775-7778
  • Fax: 802-775-7775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number01074836A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number042-0011271
License Number StateVT
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberCDR.0000787
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: