Provider Demographics
NPI:1295970549
Name:LANG, ALEXIS F (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:F
Last Name:LANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1258 W FRONT ST
Mailing Address - Street 2:P O BOX 561
Mailing Address - City:LINCROFT
Mailing Address - State:NJ
Mailing Address - Zip Code:07738-1243
Mailing Address - Country:US
Mailing Address - Phone:908-915-3488
Mailing Address - Fax:732-530-5813
Practice Address - Street 1:9401 ASTORIA BLVD
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11369-1534
Practice Address - Country:US
Practice Address - Phone:718-639-6550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152055208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice