MEDICARE: ERIN LANG PT, DPT

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	225100000X	Physical Therapist	40QA02027200	NJ

General Provider Information

NPI Number	:	1629747456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN LANG PT, DPT

Provider Business Mailing Address
First Line	:	310 NEW RD
Second Line	:
City	:	PARSIPPANY
State	:	NJ
Zip	:	07054-4273
Country	:	US
Telephone Number	:	973-396-8667
Fax Number	:	973-396-8668

Provider Business Practice Location Address
First Line	:	310 NEW RD
Second Line	:
City	:	PARSIPPANY
State	:	NJ
Zip	:	07054-4273
Country	:	US
Telephone Number	:	973-396-8667
Fax Number	:	973-396-8668

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

Provider Enumeration Date	:	09/07/2021
Last Update Date	:	09/13/2021

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