Individual
AMBER L LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
62 HACKETT BLVD, SUITE 2, ALBANY, NY 12209-1756
(518) 465-3318
Mailing address
62 HACKETT BLVD, SUITE 2, ALBANY, NY 12209-1756
(518) 465-3318
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
421043
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
421043
NYS LICENSE #
NY
Enumeration date
09/15/2011
Last updated
09/15/2011
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