Provider Demographics
NPI:1013959634
Name:LANGSDORF, PHILIP (PHD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:
Last Name:LANGSDORF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 PEOPLES PLZ
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5707
Mailing Address - Country:US
Mailing Address - Phone:302-832-1282
Mailing Address - Fax:302-832-7313
Practice Address - Street 1:1400 PEOPLES PLZ
Practice Address - Street 2:SUITE 204
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5707
Practice Address - Country:US
Practice Address - Phone:302-832-1282
Practice Address - Fax:302-832-7313
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB10000298103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE854619A39Medicare ID - Type Unspecified