Individual
MS. CATHERINE G LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
12510 QUEENS BLVD, KEW GARDENS, NY 11415-1519
(718) 261-0444
Mailing address
4031 157TH ST, FLUSHING, NY 11354-5045
(718) 445-1673
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005641
NY
Other
Enumeration date
03/19/2007
Last updated
08/23/2010
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