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Individual

MIRANDA LANGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C, RD

Contact information

Practice address
282 WASHINGTON ST, HARTFORD, CT 06106-3322
(860) 545-9000
Mailing address
9561 ANDREW DR, TWINSBURG, OH 44087-2708
(216) 375-0525

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA185166
CT

Other

Enumeration date
11/10/2017
Last updated
07/09/2019
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