Provider Demographics
NPI:1003691569
Name:LANGEY, MADISON ROSE (OTR/L)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:ROSE
Last Name:LANGEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MCCHESNEY AVE APT E-8
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-8868
Mailing Address - Country:US
Mailing Address - Phone:315-314-1011
Mailing Address - Fax:
Practice Address - Street 1:700 S PEARL ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12202-1086
Practice Address - Country:US
Practice Address - Phone:518-427-2214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028269-01225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist