Individual
PROF. MARY LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2665 RIDGEWAY AVE, SUITE 460, ROCHESTER, NY 14626
(585) 581-6790
(585) 581-6793
Mailing address
2665 RIDGEWAY AVE, SUITE 460, ROCHESTER, NY 14626-4296
(585) 581-6790
(585) 581-6793
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F301226
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03299992
—
NY
Enumeration date
07/13/2006
Last updated
06/15/2016
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