Provider Demographics
NPI:1356405401
Name:LANGEN, JOSEPH G (PHD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:G
Last Name:LANGEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:598 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-2828
Mailing Address - Country:US
Mailing Address - Phone:585-343-2693
Mailing Address - Fax:
Practice Address - Street 1:598 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-2828
Practice Address - Country:US
Practice Address - Phone:585-343-2693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5045103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMDE768Medicare UPIN
NY00020207701Medicare UPIN
NY0013227Medicare UPIN
NYBB2865Medicare ID - Type UnspecifiedMEDICARE
NY505045-0Medicare UPIN
NY6103280Medicare UPIN