Provider Demographics
NPI:1003817628
Name:LANGER, ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:LANGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10727 71ST AVE
Mailing Address - Street 2:SUITE 2-282
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4724
Mailing Address - Country:US
Mailing Address - Phone:718-261-0179
Mailing Address - Fax:
Practice Address - Street 1:10727 71ST AVE
Practice Address - Street 2:SUITE 2-282
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4724
Practice Address - Country:US
Practice Address - Phone:718-261-0179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-04
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY189467207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
620895Medicare UPIN