Individual
NAOMI LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
117 JAYNE AVE, PATCHOGUE, NY 11772-2834
(631) 275-1627
Mailing address
117 JAYNE AVE, PATCHOGUE, NY 11772-2834
(631) 275-1627
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
07/20/2019
Last updated
07/20/2019
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