Lange, David Otto
Lange, David Otto is an sole proprietor health care provider with primary practice located at 2205 Nott St , Niskayuna NY 12309-4346. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Lange, David Otto can be contacted via phone (518) 374-3324.Contact Information
Primary practice address
2205 Nott St
Niskayuna NY 12309-4346
Phone: (518) 374-3324
Fax: (518) 374-3325
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 040252 | New York |
Profile Details
| NPI number | 1114212255 |
|---|---|
| LBN Legal business name | Lange, David Otto |
| Credentials | BS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 16th, 2011 |
| Last updated | Jun 16th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114212255 | NPPES |
| New York | MEDICAID | 00536094 |
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