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General NPI Number Information
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NPI Number | 1225020688
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Entity Type | Individual
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Provider Name | KERI MARIE LAVIGNE-LANGENSTEIN MD
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Gender | Female
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 09/22/2011
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Provider Practice Location Address
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Address Line | 7600 CENTRAL AVE MARC J MEDWAY MD PC
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City | PHILADELPHIA
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State | PA
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Zip | 19111-2442
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Country | US
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Telephone | 215-728-3736
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Fax | 215-728-3354
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Provider Business Mailing Address
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Address Line | PO BOX 602 MARC J MEDWAY MD PC
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City | GWYNEDD VALLEY
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State | PA
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Zip | 19437-0602
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Country | US
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Telephone | 215-542-7260
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Fax | 215-542-1012
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD058349L
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License Number State | PA
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