Provider Demographics
NPI:1497077655
Name:LANGIS, MICHELE K (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:K
Last Name:LANGIS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WILLOW PARK CTR
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-1001
Mailing Address - Country:US
Mailing Address - Phone:516-293-3033
Mailing Address - Fax:
Practice Address - Street 1:100 WILLOW PARK CTR
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-1001
Practice Address - Country:US
Practice Address - Phone:516-293-3033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043719183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist