Provider Demographics
NPI:1457317380
Name:LANGO, RICHARD P (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:P
Last Name:LANGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 912
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05702-0912
Mailing Address - Country:US
Mailing Address - Phone:802-775-7778
Mailing Address - Fax:802-775-7775
Practice Address - Street 1:73 CENTER ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4046
Practice Address - Country:US
Practice Address - Phone:802-775-7778
Practice Address - Fax:802-775-7775
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01074836A2084N0400X
VT042-00112712084N0400X
COCDR.00007872084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTI12222Medicare UPIN