Provider Demographics
NPI:1700108016
Name:LANGBERG, HANNAH H (NP)
Entity Type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:H
Last Name:LANGBERG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:HYUN
Other - Middle Name:JOO
Other - Last Name:OH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9900 BREN RD E
Mailing Address - Street 2:MAIL ROUTE MN 008-B213
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-9664
Mailing Address - Country:US
Mailing Address - Phone:201-820-8079
Mailing Address - Fax:
Practice Address - Street 1:458 WESTVIEW AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-5105
Practice Address - Country:US
Practice Address - Phone:201-820-8079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-28
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00276600363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0727962Medicaid