1891772620 NPI number — DR. THOMAS P LANG MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891772620 NPI number — DR. THOMAS P LANG MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LANG
Provider First Name:
THOMAS
Provider Middle Name:
P
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891772620
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
150 E MANNING ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PROVIDENCE
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02906-5109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-272-2020
Provider Business Mailing Address Fax Number:
401-421-5979

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
150 E MANNING ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PROVIDENCE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02906-5109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-272-2020
Provider Business Practice Location Address Fax Number:
401-421-5979
Provider Enumeration Date:
12/22/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  MD07306 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0019786 . This is a "NEIGHBORHOOD MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2834 . This is a "NEIGHBORHOOD RI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: J11768 . This is a "MASS BLUE SHIELD" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 7002180 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0800658 . This is a "UNITED" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 150626 . This is a "HARVARD" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 150626 . This is a "BLUE CHIP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 180039136 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: M17024 . This is a "BCBS MA GROUP #" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 5674203 . This is a "AETNA" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: M17477 . This is a "BCBS MA GROUP #" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 26587 . This is a "RI BLUE SHIELD" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 6352840 . This is a "CIGNA" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 9001520 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 402462 . This is a "TUFTS" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




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