Provider Demographics
NPI:1659446367
Name:LANGIULLI, RICHARD ALFONSO (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALFONSO
Last Name:LANGIULLI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 BRONXDALE AVE
Mailing Address - Street 2:THIRD FLOOR SUITE 303
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462
Mailing Address - Country:US
Mailing Address - Phone:718-792-7972
Mailing Address - Fax:718-792-8311
Practice Address - Street 1:2016 BRONXDALE AVE
Practice Address - Street 2:THIRD FLOOR SUITE 303
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462
Practice Address - Country:US
Practice Address - Phone:718-792-7972
Practice Address - Fax:718-792-8311
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04647711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice