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NPI Code Detail

MEDICARE: RICHARD G. LANGELLOTTI, OD

MEDICARE: RICHARD G. LANGELLOTTI, OD
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
1152WC0802XCorneal and Contact Management Optometrist1667NC
2152W00000XOptometrist1667NC

General Provider Information

NPI Number : 1588006100
Entity Type Code : Organization
Provider Name (Legal Business Name) : RICHARD G. LANGELLOTTI, OD
Provider Business Mailing Address
First Line : 2310 FINLEY RIDGE LN
Second Line :
City : RALEIGH
State : NC
Zip : 27615-4047
Country : US
Telephone Number : 919-924-6147
Fax Number : 252-822-0033
Provider Business Practice Location Address
First Line : 1205 EASTERN AVE
Second Line :
City : NASHVILLE
State : NC
Zip : 27856-1814
Country : US
Telephone Number : 252-291-3939
Fax Number : 252-822-0033
Authorized Official
Title or Position : SOLE PROPRIETOR
Name : DR. RICHARD GREGORY LANGELLOTTI
Credential : O.D.
Telephone Number : 919-924-6147
Provider Enumeration Date : 07/24/2013
Last Update Date : 08/19/2015

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