MEDICARE: KATELYNN JOSEPHINE LANG M.S. ED., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	029274	NY

General Provider Information

NPI Number	:	1528604782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYNN JOSEPHINE LANG M.S. ED., CCC-SLP

Provider Business Mailing Address
First Line	:	4845 TRANSIT RD APT 413
Second Line	:
City	:	DEPEW
State	:	NY
Zip	:	14043-4662
Country	:	US
Telephone Number	:	716-462-8269
Fax Number	:

Provider Business Practice Location Address
First Line	:	6048 GODFREY RD
Second Line	:
City	:	BURT
State	:	NY
Zip	:	14028-9722
Country	:	US
Telephone Number	:	716-731-6800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2019
Last Update Date	:	08/01/2023

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Directions to “ KATELYNN JOSEPHINE LANG M.S. ED., CCC-SLP” Practice Location

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