=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043346471
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEUROLOGY MICROPRACTICE, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2007
-----------------------------------------------------
Last Update Date | 07/19/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 73 CENTER ST
-----------------------------------------------------
City | RUTLAND
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05701-4046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-775-7778
-----------------------------------------------------
Fax | 802-775-7775
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 912
-----------------------------------------------------
City | RUTLAND
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05702-0912
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-775-7778
-----------------------------------------------------
Fax | 802-775-7775
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. RICHARD P LANGO
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 802-775-7778
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | 042-0011271
-----------------------------------------------------
License Number State | VT
-----------------------------------------------------