Provider Demographics
NPI:1912036245
Name:LANGONE, PATRICK R (RDO)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:R
Last Name:LANGONE
Suffix:
Gender:M
Credentials:RDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 NORTH AVENUE
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-3320
Mailing Address - Country:US
Mailing Address - Phone:781-245-7263
Mailing Address - Fax:781-245-4518
Practice Address - Street 1:333 NORTHN AVENUE
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-3320
Practice Address - Country:US
Practice Address - Phone:781-245-7263
Practice Address - Fax:781-245-4518
Is Sole Proprietor?:No
Enumeration Date:2007-03-04
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA1348156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician