Provider Demographics
NPI:1720675499
Name:LANGER, JOSHUA
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:
Last Name:LANGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 WILLOWBROOK RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6511
Mailing Address - Country:US
Mailing Address - Phone:347-821-1891
Mailing Address - Fax:
Practice Address - Street 1:1132 WILLOWBROOK RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6511
Practice Address - Country:US
Practice Address - Phone:347-821-1891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician