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General NPI Number Information
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NPI Number | 1699852038
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Entity Type | Organization
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Legal Business Name | FREDERICK H LANGE, INC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 2205 NOTT ST
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City | NISKAYUNA
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State | NY
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Zip | 12309-4346
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Country | US
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Telephone | 518-374-3324
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Fax | 518-374-3325
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Provider Business Mailing Address
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Address Line | 2205 NOTT ST
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City | NISKAYUNA
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State | NY
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Zip | 12309-4346
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Country | US
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Telephone | 518-374-3324
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Fax | 518-374-3325
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DANIEL THOMAS LANGE
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Credential | RPH
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Telephone | 518-374-3324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 017708
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License Number State | NY
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