Provider Demographics
NPI:1346496049
Name:LANG, KATHLEEN FINNOUALA (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:FINNOUALA
Last Name:LANG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GROTON PKWY
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-4540
Mailing Address - Country:US
Mailing Address - Phone:585-359-3710
Mailing Address - Fax:585-359-2372
Practice Address - Street 1:100 GROTON PKWY
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4540
Practice Address - Country:US
Practice Address - Phone:585-359-3710
Practice Address - Fax:585-359-2372
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY513241-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00357240Medicaid