Provider Demographics
NPI:1912407602
Name:POST-LANGAN, KERRY RITA (LPN)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:RITA
Last Name:POST-LANGAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:KERRY
Other - Middle Name:RITA
Other - Last Name:LANGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:65 FRANKLIN STREET
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-3601
Mailing Address - Country:US
Mailing Address - Phone:516-710-0147
Mailing Address - Fax:
Practice Address - Street 1:65 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-3601
Practice Address - Country:US
Practice Address - Phone:516-710-0147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-19
Last Update Date:2018-04-26
Deactivation Date:2018-03-15
Deactivation Code:
Reactivation Date:2018-04-23
Provider Licenses
StateLicense IDTaxonomies
NY219036-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse