Provider Demographics
NPI:1518087196
Name:LANGELLA, NIAMH MARIA (BSC(HONS))
Entity Type:Individual
Prefix:MRS
First Name:NIAMH
Middle Name:MARIA
Last Name:LANGELLA
Suffix:
Gender:F
Credentials:BSC(HONS)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:BREEZY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11697-1217
Mailing Address - Country:US
Mailing Address - Phone:718-318-5677
Mailing Address - Fax:
Practice Address - Street 1:10322 ROCKAWAY BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ROCKAWAY PARK
Practice Address - State:NY
Practice Address - Zip Code:11694-2744
Practice Address - Country:US
Practice Address - Phone:718-318-8550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019872225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist