Provider Demographics
NPI:1801668199
Name:LANG, DIANE (MA, PPC)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:LANG
Suffix:
Gender:F
Credentials:MA, PPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:FLANDERS
Mailing Address - State:NJ
Mailing Address - Zip Code:07836-9156
Mailing Address - Country:US
Mailing Address - Phone:516-220-9047
Mailing Address - Fax:973-448-3660
Practice Address - Street 1:207 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-9156
Practice Address - Country:US
Practice Address - Phone:516-220-9047
Practice Address - Fax:973-448-3660
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator