Provider Demographics
NPI:1467450452
Name:LANGMAN, RONALD (DO)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
Last Name:LANGMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74-01 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-7467
Mailing Address - Country:US
Mailing Address - Phone:718-821-5500
Mailing Address - Fax:718-456-0778
Practice Address - Street 1:74-01 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7467
Practice Address - Country:US
Practice Address - Phone:718-821-5500
Practice Address - Fax:718-456-0778
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193881207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1579304Medicaid
G01333Medicare UPIN
NY1579304Medicaid