MEDICARE: DR. EVE ELLEN LANGNER

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	103TC0700X	Clinical Psychologist	013625-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669670022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EVE ELLEN LANGNER

Provider Business Mailing Address
First Line	:	102 W 75TH ST
Second Line	:	SUITE 107
City	:	NEW YORK
State	:	NY
Zip	:	10023-1904
Country	:	US
Telephone Number	:	212-799-2194
Fax Number	:

Provider Business Practice Location Address
First Line	:	102 WEST 75TH STREET
Second Line	:	SUITE 107
City	:	NEW YORK
State	:	NY
Zip	:	10023-1904
Country	:	US
Telephone Number	:	212-799-2194
Fax Number	:

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

Provider Enumeration Date	:	07/06/2007
Last Update Date	:	07/08/2007

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