Provider Demographics
NPI:1871636423
Name:LANGEVIN, STEVEN RONALD (SLP)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:RONALD
Last Name:LANGEVIN
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-2819
Mailing Address - Country:US
Mailing Address - Phone:516-984-8044
Mailing Address - Fax:
Practice Address - Street 1:58 2ND AVE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA PARK
Practice Address - State:NY
Practice Address - Zip Code:11762-2819
Practice Address - Country:US
Practice Address - Phone:516-984-8044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013828-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist