Provider Demographics
NPI:1598309353
Name:JOHN T LANGFITT LLC
Entity Type:Organization
Organization Name:JOHN T LANGFITT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:LANGFITT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:585-831-1461
Mailing Address - Street 1:132 EASTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-1031
Mailing Address - Country:US
Mailing Address - Phone:585-831-1461
Mailing Address - Fax:585-486-6289
Practice Address - Street 1:900 WESTFALL RD STE D
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2635
Practice Address - Country:US
Practice Address - Phone:585-831-1461
Practice Address - Fax:585-486-6289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-04
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center