Provider Demographics
NPI:1235641515
Name:LANG, CATHLEEN JO (RN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:CATHLEEN
Middle Name:JO
Last Name:LANG
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 EAGLEWOOD AVE.
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14220
Mailing Address - Country:US
Mailing Address - Phone:716-512-3654
Mailing Address - Fax:
Practice Address - Street 1:43 EAGLEWOOD AVE.
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14220
Practice Address - Country:US
Practice Address - Phone:716-512-3654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY492975-1163WM0102X
NYL-41725163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn