Provider Demographics
NPI:1578701843
Name:LANGLITZ, IRIS M (OTR/L)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:M
Last Name:LANGLITZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 SYCAMORE RD
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-1426
Mailing Address - Country:US
Mailing Address - Phone:845-628-5428
Mailing Address - Fax:
Practice Address - Street 1:41 SYCAMORE RD
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-1426
Practice Address - Country:US
Practice Address - Phone:845-628-5428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-26
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006239-1171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor