MEDICARE: JULIANNE LANGSTON PA-C

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	363A00000X	Physician Assistant	25MP00501000	NJ
2	363A00000X	Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	25MP00501000	OTHER	NJ	PHYSICIAN ASSISTANT

General Provider Information

NPI Number	:	1770050171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANNE LANGSTON PA-C

Provider Business Mailing Address
First Line	:	12 LONG BOW DR
Second Line	:
City	:	SEWELL
State	:	NJ
Zip	:	08080-1656
Country	:	US
Telephone Number	:	856-649-3733
Fax Number	:

Provider Business Practice Location Address
First Line	:	1505 W SHERMAN AVE
Second Line	:
City	:	VINELAND
State	:	NJ
Zip	:	08360-7059
Country	:	US
Telephone Number	:	856-641-8000
Fax Number	:

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

Provider Enumeration Date	:	10/24/2018
Last Update Date	:	03/03/2026

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Directions to “ JULIANNE LANGSTON PA-C” Practice Location

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