Provider Demographics
NPI:1982669537
Name:LANG, ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:LANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 WOODLAND RD
Mailing Address - Street 2:2 ND FLOOR
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-2342
Mailing Address - Country:US
Mailing Address - Phone:203-318-5200
Mailing Address - Fax:203-318-5203
Practice Address - Street 1:11 WOODLAND RD
Practice Address - Street 2:2 ND FLOOR
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-2342
Practice Address - Country:US
Practice Address - Phone:203-318-5200
Practice Address - Fax:203-318-5203
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT17799207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB38177Medicare UPIN