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General NPI Number Information
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NPI Number | 1962006916
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Entity Type | Individual
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Provider Name | SUSAN M LANG PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 100 BROOKSBY VILLAGE DR
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City | PEABODY
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State | MA
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Zip | 01960-1438
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Country | US
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Telephone | 978-326-2350
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Fax | 978-536-6937
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Provider Business Mailing Address
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Address Line | 47 OAK RIDGE CIR
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City | LYNN
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State | MA
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Zip | 01904-1527
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Country | US
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Telephone | 781-690-3547
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH18403
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License Number State | MA
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