Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 189467 | NY |
NPI | 1003817628 |
---|---|
Provider Name | Dr. Robert Langer |
First Address | Forest Hills, NY 11375-4724 |
Second Address | Forest Hills, NY 11375-4724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2005 |
Last Update Date | 03/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
620895 | (02) |