Provider Demographics
NPI:1083886220
Name:LANGILL, PATRICIA A (FNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:LANGILL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 CHESTNUT ST
Mailing Address - Street 2:P.O. BOX 920369
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2578
Mailing Address - Country:US
Mailing Address - Phone:781-444-5515
Mailing Address - Fax:781-444-1866
Practice Address - Street 1:87 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2578
Practice Address - Country:US
Practice Address - Phone:781-444-5515
Practice Address - Fax:781-444-1866
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA103796207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9730176Medicaid