Individual
DR. STEPHAN CHARLES LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 ASYLUM AVE, SUITE 3208, HARTFORD, CT 06105-1770
(860) 522-7121
(860) 244-3516
Mailing address
270 FARMINGTON AVE, STE 102, FARMINGTON, CT 06032-1920
(860) 549-8276
(860) 674-8084
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
025612
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004001442
—
CT
Enumeration date
06/08/2006
Last updated
03/15/2018
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