Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 1667 | NC |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 1667 | NC |
NPI | 1154326163 |
---|---|
Provider Name | Dr. Richard Gregory Langellotti |
First Address | Raleigh, NC 27615-4047 |
Second Address | Wilson, NC 27893-3461 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 22/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
891222L | (05) | NC |
U26334 | (02) |