Provider Demographics
NPI:1467471847
Name:LANGBART, MITCHELL MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:MARK
Last Name:LANGBART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5900 BURDICK STREET SUITE 207
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-4230
Mailing Address - Country:US
Mailing Address - Phone:315-656-2070
Mailing Address - Fax:315-656-2060
Practice Address - Street 1:5900N BURDICK ST 207
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9464
Practice Address - Country:US
Practice Address - Phone:315-656-2070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2016-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1362172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F07282Medicare UPIN