Provider Demographics
NPI:1326182098
Name:LANG, ROBIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:
Last Name:LANG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:ROBIN
Other - Last Name:LANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:90 W MAIN ST
Mailing Address - Street 2:FREEHOLD
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2144
Mailing Address - Country:US
Mailing Address - Phone:732-308-0692
Mailing Address - Fax:
Practice Address - Street 1:90 W MAIN ST
Practice Address - Street 2:FREEHOLD
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2144
Practice Address - Country:US
Practice Address - Phone:732-308-0692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3324103T00000X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent