Provider Demographics
NPI:1235563602
Name:CARON LANGAN MASTRONE PHD PC
Entity Type:Organization
Organization Name:CARON LANGAN MASTRONE PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARON
Authorized Official - Middle Name:LANGAN
Authorized Official - Last Name:MASTRONE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD PC
Authorized Official - Phone:251-476-9011
Mailing Address - Street 1:2450A OLD SHELL RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-3020
Mailing Address - Country:US
Mailing Address - Phone:251-476-9011
Mailing Address - Fax:
Practice Address - Street 1:2450A OLD SHELL RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3020
Practice Address - Country:US
Practice Address - Phone:251-476-9011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1023103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000046975Medicare UPIN