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General NPI Number Information
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NPI Number | 1063646313
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Entity Type | Individual
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Provider Name | RUSSELL LANGAN MD
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Gender | Male
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Dates
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Enumeration Date | 05/14/2009
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Last Update Date | 09/28/2017
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Provider Practice Location Address
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Address Line | 94 OLD SHORT HILLS ROAD SAINT BARNABAS MEDICAL CENTER DEPARTMENT OF SURGERY
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City | LIVINGSTON
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State | NJ
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Zip | 07039
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Country | US
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Telephone | 973-322-5995
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Fax |
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Provider Business Mailing Address
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Address Line | DEPARTMENT OF SURGERY 94 OLD SHORT HILLS ROAD
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5672
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Country | US
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Telephone | 917-922-5961
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | 25MA10099400
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License Number State | NJ
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