Individual
MIMEROSE P. LANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
350 ENGLE ST, ENGLEWOOD, NJ 07631-1808
(201) 292-1400
Mailing address
712 E 27TH ST APT 3A, BROOKLYN, NY 11210-2217
(646) 591-9964
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ013180600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0998974
—
NJ
Enumeration date
06/19/2022
Last updated
03/26/2025
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