Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 25MA05350300 | NJ |
NPI | 1144399858 |
---|---|
Provider Name | John E Langenfeld |
First Address | Tinton Falls, NJ 07701-4947 |
Second Address | New Brunswick, NJ 08901-1962 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 31/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6179304 | (05) | NJ |
F58802 | (02) | NJ |