Provider Demographics
NPI:1700142627
Name:LANGDON, AMI TAILOR (MD)
Entity Type:Individual
Prefix:
First Name:AMI
Middle Name:TAILOR
Last Name:LANGDON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMI
Other - Middle Name:
Other - Last Name:TAILOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:HUNTERDON PEDIATRIC ASSOCIATES
Mailing Address - Street 2:6 SAND HILL ROAD, SUITE 102
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822
Mailing Address - Country:US
Mailing Address - Phone:908-782-6700
Mailing Address - Fax:908-788-5861
Practice Address - Street 1:HUNTERDON PEDIATRIC ASSOCIATES
Practice Address - Street 2:6 SAND HILL ROAD, SUITE 102
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822
Practice Address - Country:US
Practice Address - Phone:908-782-6700
Practice Address - Fax:908-788-5861
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA074381208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP01593953OtherRAILROAD MEDICARE
GA003138044BMedicaid
GA003138044BMedicaid