Provider Demographics
NPI:1437217692
Name:LANGELLA, PEGGY VERONICA (LPN)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:VERONICA
Last Name:LANGELLA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 HIGH CT
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-5618
Mailing Address - Country:US
Mailing Address - Phone:845-462-8379
Mailing Address - Fax:
Practice Address - Street 1:15 HIGH CT
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-5618
Practice Address - Country:US
Practice Address - Phone:845-462-8379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245816-1164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse