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Individual

MICHAEL J LANGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
29 N CHENANGO ST, GREENE, NY 13778-1139
(607) 656-4485
(607) 656-4648
Mailing address
29 N CHENANGO ST, GREENE, NY 13778-1139
(607) 656-4485
(607) 656-4648

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
UT4149
NY
174400000X
Specialist
T89592
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00728258
NY
Enumeration date
10/05/2006
Last updated
09/11/2025
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