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NPI Code Detail

MEDICARE: REANN AMBER LANG CCC-SLP

MEDICARE: REANN AMBER LANG 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
1390200000XStudent in an Organized Health Care Education/Training ProgramNY
2235Z00000XSpeech-Language Pathologist033717NY

General Provider Information

NPI Number : 1881337608
Entity Type Code : Individual
Provider Name (Legal Business Name) : REANN AMBER LANG CCC-SLP
Provider Business Mailing Address
First Line : 770 GROTE ST
Second Line :
City : BRONX
State : NY
Zip : 10460-1007
Country : US
Telephone Number : 718-561-2052
Fax Number :
Provider Business Practice Location Address
First Line : 770 GROTE ST
Second Line :
City : BRONX
State : NY
Zip : 10460-1007
Country : US
Telephone Number : 718-561-2052
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2022
Last Update Date : 03/07/2026

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Directions to “ REANN AMBER LANG CCC-SLP” Practice Location

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